Hybrid Lead Care Manager, Enhanced Care Management

at Pacific Health Group

• Job title: Lead Care Manager, Enhanced Care Management
• Job type: Full Time
• Experience level: Senior
• Salary: $25 - $29 per hour
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Orland, United States

About the role

• Lead Case Manager managing comprehensive support and care coordination for members in Enhanced Care Management programs. Addressing social determinants of health while building trusting relationships through visits.

Responsibilities

• You won’t just coordinate clinical visits. You’ll respond to real-life challenges such as housing, food insecurity, and mental health, ensuring that members’ needs are addressed comprehensively.
• By forming strong, personal connections through frequent in-person visits, you’ll become a pivotal support system—someone members can rely on for comfort, guidance, and advocacy.
• Beyond paperwork and phone calls, you’ll arrange all necessary services—from setting up medical appointments and coordinating transportation to securing safe housing and financial support.
• You’ll be a consistent presence in members’ lives, making sure no detail goes overlooked and no obstacle remains unaddressed.
• Your hands-on experience will generate insights that directly influence how our ECM programs evolve, ensuring we remain responsive to community needs.
• Your Responsibilities
• Regular Face-to-Face Assessments: Conduct multiple on-site visits each month in members’ homes, shelters, or community centers.
• Use these visits to establish trust, gather first-hand insights, and address concerns right away.
• Example: While visiting a member recovering at home, you might discover that they lack mobility aids—prompting you to arrange for durable medical equipment and coordinate in-home physical therapy.
• 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.
• If a member is discharged from the hospital, you’ll set up home health visits, fill prescriptions, secure rides for follow-up appointments, and even arrange meal delivery if needed.
• Empathetic Assessments: Look beyond forms and checkboxes to truly understand members’ backgrounds, personal challenges, and aspirations.
• Remain in close contact by phone, video, and in-person visits to monitor progress, celebrate milestones, and swiftly address any new barriers.
• Identify, coordinate, and optimize local resources—such as housing assistance, job training programs, or childcare services—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.
• After each home visit, document any social, environmental, or health updates, enabling prompt collaboration with other team members and service providers.
• Use data and first-hand observations to refine care strategies, ensuring our ECM programs stay effective and deeply compassionate.
• Complete continuing education on the latest CalAIM guidelines and integrate these protocols into your daily workflow.
• Remain flexible in supporting the team, taking on additional tasks and sharing best practices to strengthen overall outcomes.

Requirements

• Must be willing to travel to Glenn 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 pass a Motor Vehicle Report (MVR) background check prior to employment.

Benefits

• 160 Hours of Paid Time Off (PTO)
• 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment
• 4 Paid Volunteer Hours per Month to support causes you care about
• 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
• Opportunities for professional development and internal growth
• Employee Discounts via Great Work Perks and Perks at Work
• Quarterly In-Person Events