Care Manager

About the role

The Team You'll Join
We are a mission-driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

More About The Opportunity

This position has been approved to be Community Worker. If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. The Care Manager will facilitate communication and coordination among all participants of the health care team and the member to ensure the services provided promote quality and cost-effective outcomes.

Contributions To The Team

• 85% - Care Management
• Affords member’s physical, functional, social and psychological status
• Affords member’s cultural and linguistic needs
• Follows up with provider care and ensures scheduled appointments
• Develops and implements a member’s specific care plan
• Reviews, modifies and updates the care plan to reflect the member’s needs
• Schedules follow-ups to assess progress towards goals and identifies barriers to meeting goals
• Provides regular outreach to assigned members along with members from a worklist and evaluates quality of service given to members according to department contact standards
• Coordinates care and services with members, members’ family members/representatives and other providers, as appropriate, including Community Supports and LTSS
• Facilitates referrals to behavioral health/substance use disorder services and identifies and makes referrals to Long-Term Support Services (LTSS) department, Community Supports and community resources
• Facilitates and participates in Interdisciplinary Care Team meetings, as applicable
• Collaborates with interdepartmental staff in case resolution as needed
• Identifies cases needing manager, director or medical director review or input, routes accordingly and closes cases according to procedures and guidelines in a timely manner
• Prepares and maintains appropriate documentation of patient care and progress within the documentation platform or care plan as appropriate
• Advocates in the member's best interest for necessary funding, treatment alternatives, timelines and coordination of care and frequent evaluations of progress and goals

• 10% - Administrative Support
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department
• Follows CalOptima Health's protocol for documenting all case interventions
• Ensures reporting of productivity metrics to supervisor

• 5% - Other
• Completes other projects and duties as assigned

What the Regulatory Agencies Need You to Possess?

n/a

Your Knowledge & Abilities To Bring To This Role

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds
• Work independently and exercise sound judgment
• Communicate clearly and concisely, both orally and in writing
• Work a flexible schedule; available to participate in evening and weekend events
• Organize, be analytical, problem-solve and possess project management skills
• Manage multiple projects and identify opportunities for internal and external collaboration
• Motivate and lead multi-program teams and external committees/coalitions
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment

Your Physical Requirements (With Or Without Accommodations)

• Ability to visually read information from computer screens, forms and other printed materials and information
• Ability to speak (enunciate) clearly in conversation and general communication
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Ways We Are Here For You

• Competitive compensation for this role
• Comprehensive benefits package
• CalPERS pension program and additional retirement packages
• Various wellness programs
• Tuition Reimbursement
• Professional development opportunities
• Career development opportunities
• Flexible scheduling

Our Work Environment

• If located at the 500, 505 Building or a remote work location: Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed
• If Located At PACE: Work is typically indoors in a clinical setting serving the frail and elderly
• If Located In The Community: Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. Employee will occasionally work outdoors in varied temperatures

Why Join Us?

We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

What's Your Next Step?

All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is July 14, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the percept