Job Title: Health Plan Nurse Coordinator Job Description The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse responsible for delivering high-quality care within various Health Services operational units. These units may include Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs. The HPNC conducts utilization management activities, performs clinical reviews, and coordinates care transitions or population health activities depending on the unit assignment. This role requires bilingual proficiency in Spanish for positions that involve member interaction. Responsibilities + Comply with HIPAA, Privacy, and Confidentiality laws and regulations. + Adhere to Health Plan, Medical Management, and Health Services policies and procedures. + Stay updated on clinical knowledge related to disease processes. + Effectively communicate, both verbally and in writing, with providers, members, vendors, and other healthcare providers in a timely and professional manner. + Function as a collaborative member of the multidisciplinary medical management team. + Identify and report quality of care concerns to management and appropriate departments for follow-up. + Support and collaborate with management, medical management, and health services team members in implementing and managing Utilization Management, Case Management, Disease Management, Population Health, Care Coordination, and Care Transition activities. + Participate in the implementation, assessment, and evaluation of quality improvement activities related to job duties. + Adhere to mandated reporting requirements based on professional licensing requirements. + Comply with regulatory standards of governing agencies. + Be flexible and open to operational changes. + Attend and actively participate in department meetings. + Engage in the development, implementation, and evaluation of department initiatives aimed at improving members' quality of care. + Stay informed about healthcare benefits, limitations, regulatory requirements, disease processes and treatment modalities, community standards of patient care, and professional nursing standards of practice. Essential Skills + Registered Nurse (RN) with active license. + Experience in utilization management and case management. + Strong organizational, multi-tasking, and time-management skills. + Clinical knowledge of adult or pediatric health conditions and disease processes. + Ability to work effectively both individually and in a cross-functional team environment. + Excellent interpersonal and communication skills. + Proficiency in writing clear, professional, and grammatically correct correspondence. + Ability to meet timelines and deadlines for daily work responsibilities and long-term projects. Additional Skills & Qualifications + Bilingual in Spanish is preferred for roles requiring member interaction. + Understanding of quality improvement theory and methods. + Experience with HEDIS medical record abstraction. Work Environment The role is based in an office setting, where the services team collaborates closely. The team includes Case Management, Pharmacy, Utilization Management, and Pediatric teams, promoting a supportive and helpful work environment. The company is mission-driven and values employee well-being, offering catered lunches weekly. If you are interested please apply here or email your resume to ggarcher @actalentservices.com Job Type & Location This is a Contract position based out of Santa Barbara, CA. Pay and Benefits The pay range for this position is $47.00 - $47.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Feb 11, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.