Registered Nurse or Licensed Clinical Social Worker Clinical Review-Hybrid-Los Angeles, California
The Clinical Consultant RN or LCSW provides clinical leadership, consultation, and oversight across care management programs. This role supports interdisciplinary care teams serving individuals with complex medical, behavioral health, and social needs, including people experiencing homelessness, serious mental illness, substance use disorders, chronic disease, and socioeconomic instability. The Clinical Consultant RN or Licensed Clinical Social Worker, LCSW partners with Care Managers, Behavioral Health clinicians, Primary Care Providers, hospitals, Managed Care Plans, and community-based organizations to ensure high-quality, whole-person, and evidence-based care. This position plays a critical role in care planning, clinical decision-making, transitions of care, medication management, quality improvement, and staff development while addressing social determinants of health and system barriers to care. Essential Duties and Responsibilities Clinical Oversight & Consultation Provide clinical support and consultation to Care Managers, and interdisciplinary care teams across care management programs. Serve as a clinical resource for chronic disease management, medication monitoring, and complex case review. Guide staff in ensuring member safety and provide immediate consultation and escalation support for high-risk clinical situations. Ensure clinical services align with evidence-based practices, regulatory standards, and program contracts, including requirements with Managed Care Plans (MCPs). Care Planning & Coordination Provide clinical oversight and tracking of comprehensive intake assessments. Participate in the development, review, and approval of patient-centered care plans, including initial plans and required updates. Monitor progress toward care plan goals and recommend adjustments based on clinical findings and data. Collaborate with Primary Care Providers, Behavioral Health clinicians, specialists, ACOs, MCOs, hospitals, and community partners to ensure services outlined in care plans are delivered. Coordinate hospital admissions, discharges, and transitions of care to promote continuity, safety, and prevent avoidable readmissions. Perform timely medication reconciliation following transitions of care and support medication adherence. Data, Quality Improvement & Compliance Use data to evaluate outcomes of targeted interventions and assist in modifying care plans and care strategies accordingly. Participate in quality improvement initiatives, audits, peer reviews, and program evaluations conducted by internal leadership, health plans, or external administrators. Monitor continuous quality improvement measures through documentation review, clinical consultation, and chart audits. Oversee charting and documentation standards to ensure compliance with contracts, program requirements, and organizational policies. Documentation & Systems Complete and review care plans, assessments, and case notes using required systems (e.g., Salesforce, EHRs, or health plan platforms). Maintain accurate, timely, and compliant documentation using SMART format where applicable. Ensure confidentiality and compliance with HIPAA and all applicable federal and state regulations. Staff Development & Team Collaboration Provide staff development training, coaching, and clinical guidance for care management staff. Participate in weekly, bi-weekly, and monthly interdisciplinary care team meetings to review client progress, evaluate program effectiveness, and develop strategies to enhance care delivery. Present cases and clinical insights during scheduled case conferences. Attend required trainings, webinars, meetings, and conferences to maintain clinical excellence and program knowledge. Support and expand programming that addresses social determinants of health and strengthens connections to community-based organizations. Promote monthly health promotion topics and materials aligned with program priorities. Expectations & Professional Standards Prioritize client health, safety, dignity, and self-determination. Communicate with professionalism, tact, and cultural humility. Demonstrate the ability to work under pressure and manage multiple complex priorities. Maintain strict confidentiality and ethical standards. Adapt effectively to change and support continuous improvement. Model openness, honesty, accountability, and teamwork. Demonstrate sensitivity to cultural, linguistic, and socioeconomic diversity. Adhere to organizational safety policies, compliance standards, and guiding principles. Required Qualifications Active and unrestricted Registered Nurse (RN) license in the State of California, in good standing. LCSW must be licensed in California. Experience working with vulnerable populations, including individuals with histories of trauma, homelessness, substance use disorders, serious mental illness, or socioeconomic stress. Strong clinical assessment, critical thinking, and problem-solving skills. Comfort working autonomously in community-based and outreach settings. Experience using data to track outcomes and measure performance. Basic computer proficiency, including email, spreadsheets, and electronic documentation. Valid California Driver’s License and proof of auto liability insurance meeting state of California minimum requirements. Knowledge and applied practice of HIPAA compliance and healthcare regulations. Preferred Qualifications Bilingual in English and Spanish. Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.
