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: Not specified
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Tulare, United States

About the role

• Lead Case Manager for Enhanced Care Management at Pacific Health Group in Tulare County, CA. Coordinating comprehensive care and support services for community members facing health challenges.

Responsibilities

• Frequent In-Person Visits to Members in Tulare County, CA
• 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.
• Comprehensive Care Coordination
• 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.
• Case Management with a Heart
• 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.
• Resource Management
• Bridge to Community Services: Identify, coordinate, and optimize local resources—such as housing assistance, job training programs, or childcare services—to ensure members’ overall wellbeing.
• Patient Advocacy
• Champion for Members’ Rights: Push for timely treatments, insurance authorizations, and fair access to services, resolving roadblocks that could hinder progress.
• Communication
• Central Point of Contact: Keep members, families, healthcare teams, and community organizations aligned on care objectives, ensuring seamless handoffs and follow-through.
• Documentation
• Detailed Reporting: Maintain meticulous records of assessments, care plans, and progress notes, ensuring transparency and accountability at every stage.
• Continuous Improvement
• Feedback and Adaptation: Use data and first-hand observations to refine care strategies, ensuring our ECM programs stay effective and deeply compassionate.
• Regulatory Compliance
• Stay Current: Keep informed about Medi-Cal, CalAIM, and other regulations, ensuring that all care management practices meet legal and quality-of-care standards.
• Professional Development
• Ongoing Learning: Attend trainings, workshops, and webinars to sharpen your skills in cultural competence, motivational interviewing, and crisis intervention.
• Other Duties
• Collaborative Mindset: Remain flexible in supporting the team, taking on additional tasks and sharing best practices to strengthen overall outcomes.

Requirements

• Residency: Must reside in Tulare County, CA
• 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