Hybrid Enhanced Care Management Lead Care Manager

at Pacific Health Group

• Job title: Enhanced Care Management Lead Care Manager
• Job type: Full Time
• Experience level: Senior
• Salary: $29 - $32 per hour
• Degree requirement: No Education Requirement
• Location requirements: Hybrid, Santa Clara, United States

About the role

• Lead Case Manager coordinating comprehensive care for members at Pacific Health Group in Santa Clara County. Establishing trust and arranging services to address members' diverse needs.

Responsibilities

• Frequent In-Person Visits to Members
• Regular Face-to-Face Assessments: Conduct multiple on-site visits each month in members’ homes, shelters, or community centers.
• Personal Connection: Use these visits to establish trust, gather first-hand insights, and address concerns right away.
• End-to-End Service Arrangement: Schedule doctor’s appointments, organize follow-up care, link members to social services, and ensure they have the resources for a full continuum of support.
• Empathetic Assessments: Look beyond forms and checkboxes to truly understand members’ backgrounds, personal challenges, and aspirations.
• Continuous Support: Remain in close contact by phone, video, and in-person visits to monitor progress, celebrate milestones, and swiftly address any new barriers.
• Bridge to Community Services: Identify, coordinate, and optimize local resources to ensure members’ overall wellbeing.
• Champion for Members’ Rights: Push for timely treatments, insurance authorizations, and fair access to services, resolving roadblocks that could hinder progress.
• Central Point of Contact: Keep members, families, healthcare teams, and community organizations aligned on care objectives, ensuring seamless handoffs and follow-through.
• Detailed Reporting: Maintain meticulous records of assessments, care plans, and progress notes, ensuring transparency and accountability at every stage.
• Use data and first-hand observations to refine care strategies, ensuring our ECM programs stay effective and deeply compassionate.
• Stay Current: Keep informed about Medi-Cal, CalAIM, and other regulations, ensuring that all care management practices meet legal and quality-of-care standards.
• Ongoing Learning: Attend trainings, workshops, and webinars to sharpen your skills in cultural competence, motivational interviewing, and crisis intervention.

Requirements

• Residency: Must reside in Santa Clara County
• Experience: 3-5 years in case management, social services, or healthcare
• Expertise: Familiarity with Medi-Cal, CalAIM, and Enhanced Care Management
• Healthcare Insight: Understanding of healthcare systems and local community resources
• Interpersonal Skills: Strong communication, empathy, and cultural competence
• Organizational Ability: Proven time management skills and attention to detail
• Technical Proficiency: Competence using case management software and related tools
• Successful completion of a pre-screen assessment required
• Possess a valid California Driver’s License (Class C minimum), maintain a personal, operable vehicle for daily business use, and carry current liability insurance that meets California's minimum legal requirements. All selected candidates will be required to complete and a background check including Motor Vehicle Report (MVR) background check prior to employment.

Benefits

• 160 hours of Paid Time Off (PTO) and Paid Sick Time
• 11 paid holidays per year, including birthday and one floating holiday after one year
• 4 paid volunteer hours per month
• Bereavement leave, including fur baby bereavement
• 90% employer-paid employee-only medical benefits
• Flexible Spending Account (FSA)
• Short-term & long-term disability, AD&D
• Employee Assistance Program (EAP)
• 401(k) with company match
• Monthly stipend
• Professional development and growth opportunities
• Employee discount programs
• Quarterly in-person events