Lead Case Manager at Pacific Health Group addressing social determinants of health. Coordinating care for underserved populations through community - based services and direct support.
About the role
- Lead Care Manager providing Enhanced Care Management for underserved populations. Managing care coordination, community engagement, and advocacy in Monterey County.
Responsibilities
- Manage a caseload of approximately 60–70 members
- Conduct 3–5 in-person visits per day (homes, shelters, community settings)
- Spend 60–70% of your time in the field
- Travel locally within Santa Clara County (mileage reimbursed)
- Coordinate care across medical, behavioral health, and community services
- Document in real-time or by end of day using internal systems
- Develop and manage individualized care plans
- Coordinate appointments, services, and follow-ups across providers
- Support transitions of care (hospital discharge, referrals, etc.)
- Build trust through consistent, in-person engagement
- Advocate for timely access to care, services, and resources
- Support members navigating housing, food access, transportation, and behavioral health needs
- Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives
- Build and maintain relationships with community-based organizations, shelters, and local resource partners
- Identify opportunities to expand community presence and improve member access to services
- Connect members to local programs and services
- Build relationships with community-based organizations
- Identify gaps in resources and escalate when needed
- Complete timely and accurate documentation
- Maintain compliance with Medi-Cal, CalAIM, and ECM program requirements
- Partner with internal teams, providers, and community stakeholders
- Participate in case conferences and care coordination meetings
Requirements
- Residency: Must reside in listed County
- Experience: 3–5 years in case management, social services, or healthcare (preferred)
- Experience with: Medi-Cal, CalAIM, or Enhanced Care Management (preferred)
- Working experience of healthcare systems and community resources is a plus
- Excellent communication, organization, and time management skills
- Proficiency with documentation systems and technology
- Ability to effectively communicate both written and verbally
- Valid California Driver’s License and active auto insurance meeting CA requirements
- Reliable personal vehicle for daily work use
- Successful completion of background check (including MVR)
- Must be able to travel up to 60-70% within the county to conduct in person visits
- Must successfully complete a Testlify skills assessment
- Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received
- Must have effective Time Management skills
- Must have internet speed of - 300+ mbps download and 25+mbps upload
- Must be proficient in technology, including documentation systems, case management platforms, and communication tools
Benefits
- $29.00 – $32.00/hour (based on experience)
- Monthly stipend + mileage reimbursement
- PTO + paid sick time
- 11 paid holidays (including birthday + floating holiday)
- 4 paid volunteer hours per month
- 90% employer-paid employee-only medical benefits
- FSA
- Short-term & long-term disability, AD&D
- Employee Assistance Program (EAP)
- 401(k) with company match
- Quarterly in-person team events
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