Lead Care Manager, Enhanced Care Management
Pacific Health Group
full-time
Posted on:
Location Type: Hybrid
Location: Tulare • California • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementcare coordinationresource managementdocumentationregulatory compliancecultural competencemotivational interviewingcrisis interventionMedi-CalCalAIM
Soft skills
communicationempathyorganizational abilitytime managementinterpersonal skillsflexibilitycollaborationtrust-buildingproblem-solvingadaptability