Job Title: Remote RN Admissions Coordinator – Long-Term Care & Rehabilitation
Company: Leading Managed Care Organization (serving California Medicaid members)
Location: Remote – Must reside and be licensed in California
Job Type: Full-Time
Department: Care Management / Utilization Management
Salary: $90,000
Position Summary:
A leading managed care organization serving California Medicaid (Medi-Cal) members is seeking an experienced and compassionate Registered Nurse (RN) to join its Care Management team in a fully remote capacity. This position is responsible for coordinating and facilitating admissions to long-term care and rehabilitation facilities for members requiring skilled or extended care services. The ideal candidate will have a background in home health, senior living intake, or long-term care admissions, along with a strong understanding of Medicaid eligibility, coverage, and placement protocols.
Key Responsibilities:
Coordinate admissions and transitions of care for members entering long-term care, skilled nursing facilities (SNFs), or subacute rehabilitation settings.
Review clinical documentation and assessments to determine the most appropriate facility placement based on member needs and Medi-Cal guidelines.
Serve as the main liaison between the health plan, facility admissions teams, discharge planners, and providers to ensure smooth and timely placements.
Manage prior authorization processes and confirm Medicaid eligibility.
Collaborate with Utilization Management and Case Management teams to ensure continuity of care and appropriate resource utilization.
Maintain accurate, up-to-date documentation in electronic systems and care management platforms.
Educate members and their families about services, benefits, and what to expect during transitions into long-term or rehabilitative care.
Ensure compliance with all applicable regulations, HIPAA requirements, and internal clinical protocols.
Qualifications:
Active, unrestricted RN license in the State of California (required)
At least 3 years of clinical experience in home health, senior living, long-term care, or admissions/intake coordination
Strong working knowledge of California Medicaid (Medi-Cal) systems, authorizations, and coverage criteria
Excellent communication, time management, and documentation skills
Proficiency with electronic medical records (EMR) and care coordination tools
Ability to work independently and remotely in a high-volume, fast-paced environment
Bilingual Spanish/English preferred, but not required
Preferred Experience:
Background with managed care organizations, health plans, or insurance case management
Familiarity with CMS and California Department of Health Care Services (DHCS) regulations
Experience in discharge planning, transitional care, or post-acute care navigation
Benefits Include:
Competitive compensation, full benefits package, 401(k) with match, generous paid time off, continuing education support, and remote work flexibility.