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In this role, you won’t just create care plans—you’ll guide members through every step of their journey, ensuring they receive the support and services needed to thrive. This role requires independence, strong time management, leadership capability, and comfort working in fast-paced, community-based environments.

Schedule: Monday – Friday | 8:30 AM – 5:00 PM Compensation: $30.00 – $35.00 per hour Location: Hybrid FLSA Status: Non-Exempt This position is an individual contributor, not a People Manager.About Pacific Health Group At Pacific Health Group, we are at the forefront of revolutionizing health and wellness through innovation, compassion, and community-driven care. Our mission is to empower members, uplift families, and positively impact the communities we serve. Our Community Supports (CS) Program helps Medi-Cal members live more independently by addressing health-related social needs. In this role, you won’t just create care plans—you’ll guide members through every step of their journey, ensuring they receive the support and services needed to thrive.What This Role Looks Like (Day-to-Day Reality) This is a highly field-based role supporting members directly in the community.<ul><li>Manage a caseload of members with complex health and social needs</li><li>Spend approximately 65% of your time in the field (homes, shelters, community settings)</li><li>Conduct in-person visits, assessments, and follow-ups</li><li>Travel locally within hiring county</li><li>Coordinate services across healthcare, behavioral health, and community resources</li><li>Participate in community outreach efforts including events, partnerships, and local engagement</li><li>Provide mentorship and support to other care managers</li><li>Document in real-time or by end of day using internal systems This role requires independence, strong time management, leadership capability, and comfort working in fast-paced, community-based environments</li></ul>What You’ll DoCare Coordination & Case Management<ul><li>Conduct comprehensive member assessments to identify health and social needs</li><li>Develop and manage individualized care plans</li><li>Coordinate appointments, services, and long-term support systems</li><li>Ensure continuity of care and consistent follow-through</li></ul>Member Engagement & Advocacy<ul><li>Build strong, trusting relationships with members and their families</li><li>Provide ongoing support through phone, video, and in-person visits</li><li>Advocate for timely care, services, and equitable access to resources</li></ul>Community Outreach & Engagement<ul><li>Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives</li><li>Build and maintain relationships with community-based organizations, shelters, and service providers</li><li>Identify opportunities to expand community presence and improve access to services</li><li>Support outreach efforts that drive member engagement and program awareness</li></ul>Community Resource Navigation<ul><li>Connect members to housing, food access, workforce programs, childcare, and other services</li><li>Strengthen partnerships with community-based organizations</li><li>Identify gaps in resources and escalate needs for program improvement</li></ul>Leadership & Team Support<ul><li>Provide guidance, mentorship, and support to care managers within the program</li><li>Assist with onboarding and training of new team members</li><li>Promote consistency, collaboration, and best practices across the team</li></ul>Documentation & Compliance<ul><li>Maintain accurate and timely documentation of all member interactions</li><li>Ensure compliance with Medi-Cal, CalAIM, and Community Supports program requirements</li><li>Track progress, outcomes, and service delivery</li></ul>Team Collaboration<ul><li>Partner with interdisciplinary teams including behavioral health, outreach, and social services</li><li>Coordinate with healthcare providers and payers to ensure seamless care delivery</li></ul>Continuous Improvement<ul><li>Identify trends and gaps in services</li><li>Provide feedback to leadership to improve care coordination strategies and partnerships</li></ul>How Success Is Measured<ul><li>Member engagement and successful care coordination outcomes</li><li>Timely and accurate documentation</li><li>Ability to manage caseload independently and effectively</li><li>Quality of mentorship and team support provided</li><li>Strength of community partnerships and outreach engagement</li><li>Compliance with program and regulatory requirements</li></ul>Who Thrives in This Role<ul><li>Is comfortable working independently in the field</li><li>Can manage complex caseloads and competing priorities</li><li>Is a strong leader and team collaborator</li><li>Is proactive, resourceful, and solution-oriented</li><li>Thrives in fast-paced, community-based environments</li><li>Enjoys engaging with the community and building relationships</li><li>Is passionate about supporting high-acuity, underserved populations</li></ul>                              Equal Employment Opportunity Pacific Health Group, along with its divisions, is a proud Equal Opportunity Employer. We embrace diversity and are devoted to creating an inclusive environment for all employees. Our commitment is to ensure equal employment opportunities for every qualified candidate, irrespective of race, religion, gender, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other status protected by federal, state, or local laws. At Pacific Health Group, we recognize the importance of accessibility and are dedicated to providing reasonable accommodations for individuals with disabilities. We believe that our strength lies in our diversity, and we are committed to building a workforce that reflects the varied communities we serve. Join us in a workplace where everyone's contributions are valued and respected.Pre-Employment Requirements Employment is contingent upon the successful completion of our pre-employment process, which includes a background check and the submission of all required documentation and new hire paperwork.AI & Human Interaction (HI) in Recruitment Pacific Health Group is committed to fairness, equity, and transparency in our hiring practices. We use AI (Artificial Intelligence) tools to help match candidate resumes against our job descriptions, focusing on qualifications, skillsets, and location. All resumes that meet these criteria are then reviewed by HI (Human Interaction) — our recruiting and HR team. Pacific Health Group remains true to our Equal Employment Opportunity (EEO) statement, ensuring that every candidate is given fair and consistent consideration.RequirementsMinimum Qualifications<ul><li>Experience: 3–5 years in case management, social services, or healthcare</li><li>Experience with: Medi-Cal, CalAIM, and Community Supports programs (preferred)</li><li>Strong understanding of healthcare systems, managed care, and community resources</li><li>Excellent communication, empathy, and cultural competence</li><li>Strong organizational and time management skills</li><li>Must be proficient in technology, including case management systems, EHR platforms, and documentation tools</li><li>Ability to document in real-time and manage member data accurately</li><li>Comfortable navigating multiple systems and communication platforms</li></ul>Work Requirements<ul><li>Ability to travel locally within hiring county</li><li>Valid California Driver’s License and reliable transportation</li><li>Ability to work in a hybrid, field-based environment</li></ul>BenefitsCompensation & Benefits<ul><li>Hourly Range:$30.00 - $35.00, depending on experience, qualifications, and internal equity</li><li>Monthly stipend</li><li>160 hours PTO + paid sick time</li><li>11 paid holidays (including birthday and floating holiday)</li><li>4 paid volunteer hours per month</li><li>90% employer-paid employee-only medical benefits</li><li>Flexible Spending Account (FSA)</li><li>Short-term & long-term disability, AD&D</li><li>Employee Assistance Program (EAP)</li><li>401(k) with company match</li><li>Professional development opportunities</li><li>Quarterly in-person events</li><li>Employee discount programs</li></ul>

Pacific Health Group

Community Support Lead Care Coordinator

Accidental Death and Dismemberment (AD&D)

Acute Care

Alliance/Partner Management

Artificial Intelligence (AI)

Behavioral Health

Case Management

Childcare

Communication Skills

Community Health

Community Programs

Community Relations

Community Support

Community and Social Services

Continuous Improvement

Data Management

Diversity

Documentation

Driver's License

Employee Assistance Plan

Equal Employment Opportunity (EEO)

Follow Through

Health Plan

Healthcare

Healthcare Providers

Human Interaction

Leadership

Maintain Compliance

Managed Care

Medi-Cal

Medical Record System

Mentoring

Needs Assessment

Onboarding

Organizational Skills

People Management

Plan Meetings

Project Tracking

Regulatory Compliance

Regulatory Requirements

Service Delivery

Social Work

Team Lead/Manager

Time Management

Trend Analysis

Willing to Travel

Workable

ADAPTED_NOW

Your leadership will encompass strategic oversight and operational management of care management functions across acute care ministries, including case management, utilization management, discharge planning, and social work services. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

HOUR

DescriptionCalling All Esteemed Leaders! Are you an exceptional strategist with a fervor for advancing healthcare? Do you excel at navigating multifaceted challenges and steering the future of healthcare delivery? If so, we have an outstanding opportunity awaiting you!The Role:As the Director of Care Management RN, you will be pivotal in executing our strategic vision. Anchored in the dynamic city of Eureka, you will collaborate with our executive team and key leaders to sculpt the future of healthcare within the region. Your leadership will encompass strategic oversight and operational management of care management functions across acute care ministries, including case management, utilization management, discharge planning, and social work services. You'll ensure seamless care transitions, optimal patient outcomes, and adherence to regulatory standards, while nurturing partnerships with medical staff and community allies. Your guidance will be instrumental in driving performance through strategic planning, data-driven insights, and continuous improvement efforts aligned with organizational goals and the Quadruple Aim.What You'll Do:<ul><li>Strategic Innovator: Formulate and execute annual strategic and operational plans that integrate clinical, administrative, and financial objectives.</li><li>Operational Leader: Direct and oversee care management, utilization management, discharge planning, and psychosocial interventions.</li><li>Collaborative Facilitator: Cultivate robust relationships with physicians, nursing, and other departments to guarantee seamless care transitions.</li><li>Performance Analyst: Track and assess utilization trends, avoidable days, and performance metrics; implement corrective actions as necessary.</li><li>Compliance Guardian: Ensure adherence to all regulatory, accreditation, and payer requirements.</li><li>Financial Steward: Manage operational and capital budgets; monitor variances and maintain productivity standards.</li><li>Mentor and Guide: Recruit, mentor, and develop staff; ensure ongoing education and performance evaluations.</li><li>Community Liaison: Act as a liaison for community care partners to uphold continuity of care.</li><li>Quality Advocate: Lead quality improvement initiatives to enhance patient experiences and outcomes.</li><li>Reporting Specialist: Provide regular updates to regional and ministry leadership on care management performance.</li><li>Learning Champion: Promote a culture of learning and excellence, fostering continuous professional development of staff and self.</li><li>Committee Contributor: Participate and chair (co-chair) hospital/medical staff committee meetings as required.</li></ul>What You'll Bring:<ul><li>Educational Background: Bachelor's Degree in Nursing required; Master's Degree in Nursing or related healthcare field from an accredited program (Preferred).</li><li>Experience: 5 years of relevant experience in an acute healthcare setting in care management, coupled with 3 years of progressive leadership experience.</li><li>Licensure: California Registered Nurse License upon hire.</li><li>Leadership Alignment: Leadership abilities consistent with the mission, vision, and values of the Health System.</li><li>Expert Knowledge: Principles and practices of acute care case management and evidence-based care.</li><li>Core Competencies: Strong leadership, strategic thinking, team-building skills; effective communication, negotiation, and relationship-building abilities.</li><li>Technical Skills: Proficiency in Microsoft Office Suite and familiarity with case management software.</li><li>Regulatory Acumen: Knowledge of requirements and eligibility parameters for payers, MediCal, and Medicare.</li><li>Multi-Tasking Ability: Capacity to manage multiple priorities and adapt to changing conditions.</li><li>Clinical Expertise: Strong foundation of clinical assessment skills for managing care of clients with complex medical, emotional, and social needs.</li><li>Communication Proficiency: Effective oral and written communication and negotiation skills in conflict situations, skillfully balancing demands without alienating others.</li><li>Problem-Solving Skills: Critical thinking and problem-solving abilities to devise innovative solutions and achieve desired results.</li><li>Interpersonal Excellence: Exceptional interpersonal skills with demonstrated diplomacy and teamwork ability; effective as a team leader guiding actions to accomplish objectives.</li><li>Judgment and Decision-Making: Ability to exercise sound judgment for independent decision-making and seek consultation when deviating from organizational objectives.</li></ul>Why Join Us?<ul><li>Impactful Work: Be part of an organization transforming healthcare and enhancing countless lives.</li><li>Empowerment and Innovation: Experience the autonomy and support needed to bring innovative ideas to fruition.</li><li>Professional Collaboration: Work alongside a team of talented and dedicated professionals passionate about their roles.</li><li>Dynamic Environment: Embrace the challenges and rewards of a fast-paced, ever-evolving industry.</li><li>Vibrant Locale: Enjoy Eureka’s stunning natural beauty and thriving cultural scene.</li></ul>Ready to Shape the Future of Healthcare? If you're a visionary leader passionate about healthcare, we encourage you to apply! Join our team and contribute to creating a healthier future for all.About ProvidenceAt Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.About the TeamThe Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Northern California, Providence provides health care services to Eureka, Fortuna, Healdsburg, Napa, Petaluma and Santa Rosa.Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.Requsition ID: 412962 Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Leadership Department: 7800 CASE MGMT Address: CA Eureka 2700 Dolbeer St Work Location: St Joseph Hospital Eureka Workplace Type: On-site Pay Range: $107.55 - $169.79 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.PandoLogic. Category:Healthcare, Keywords:Clinical Services Director, Location:Fortuna, CA-95540

Providence Health and Services

Director Care Management RN

Best Practices

Cancer

Capital Budgeting

Cardiology

Category Management

Clinical Competency

Clinical Medicine

Corrective Action

Discharge Plans

Educational Evaluation

Emergency Care

Emergency Services

Federal Laws and Regulations

Genetics

Health Education

Hospital

Interpersonal Skills

Medicare

Microsoft Office

Multitasking

Negotiation Skills

Neonatal Intensive Care Unit (NICU)

Neuroscience

Nursing

Operational Strategy

Operations Management

Operations Planning

Orthopedics

Pediatric Intensive Care Unit (PICU)

Performance Analysis

Performance Metrics

Performance Reviews

Presentation/Verbal Skills

Problem Solving Skills

Quality Assurance

Quality Management

Registered Nurse (RN)

Regulations

Sculpture

Staff Development

Strategic Planning

Team Player

Utilization Management

Writing Skills

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Community Support Lead Care CoordinatorPacific Health Group

Director Care Management RNProvidence Health and Services

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