About the Role A leading regional Medi-Cal managed care plan is seeking a detail-oriented Senior Care Integration Registered Nurse (RN) for a full-time, temporary remote position scheduled through December 2026, with potential extension into 2027 based on business needs. In this role, you will perform quality and oversight record reviews for Enhanced Care Management (ECM) program providers, ensuring non-duplicative, high-quality care across the provider network. Pay Range Zone 1 (Santa Cruz, San Benito, Monterey, Bay Area, Sacramento, Los Angeles, San Diego): $49.00 - $63.00/hr Zone 2 (Mariposa, Merced, Fresno, Bakersfield, Central Valley, SLO): $46.00 - $59.00/hr Key Responsibilities Perform clinical quality reviews and audit provider charts (target minimum: 20 charts per day). Evaluate Enhanced Care Management (ECM), Community Supports (CS), and Transitions of Care (TOC) service delivery to ensure compliance and care integrity. Provide written audit feedback and clear communications to external ECM providers detailing findings and areas for improvement. Coordinate across internal departments, external providers, and community agencies to streamline care continuum transitions. Assist with program oversight, compliance reporting, and provider training initiatives. Required Qualifications Active, unrestricted Registered Nurse (RN) license issued by the State of California. Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN). 5+ years of overall RN experience with at least 3+ years in Case Management. Strong clinical judgment, record review skills, and high attention to detail. Excellent written communication skills for formal audit correspondence. Preferred Qualifications 5+ years of dedicated Case Management experience. Bachelor of Science in Nursing (BSN). National Case Management Certification (e.g., CCM). Background in public health, community health, home health, or population health. Bilingual skills (English/Spanish or English/Hmong).

Work Environment & Details Schedule:

Monday - Friday, 8:00 AM - 5:00 PM PST.

Location:

100% Remote (Must reside in California).

Equipment:

Full IT setup (laptop, monitor, headset) provided.

• We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

• As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.