Care Manager - ECM
Vista Community Clinic · La Habra, CA · 2 wk ago
Healthcare$23–$25/hrFull-time
Why VCC?
- Winner of the 2025 HRSA Gold Medal for Outstanding Care
- Nationally recognized as a National Quality Leader in Behavioral Health and Diabetes
- Affirmative action employer
About the role
Operate as part of the patients’ multi-disciplinary care team and responsible for interacting directly with the assigned health plan’s ECM Members and/or family, Authorized Representatives, caretakers and/or other authorized support person(s) as appropriate to coordinate all aspects of ECM and any Community Supports.
Responsibilities
- Care coordinate designated populations of focus panel to ensure appropriate input is obtained to effectively coordinate all primary, behavioral, developmental, oral health, LTSS, ILOS and other services that address social determinants of health (SDOH).
- Develop an individualized comprehensive management care plan integrating clinical and non-clinical needs to achieve health goals designed to improve functional status, health status, or prevent decline.
- Coach patients and caregivers using evidence-based motivational interviewing techniques and trauma-informed care language to address critical issues to help patients develop achievable self-management care plan goals, presenting new skills using a step-by-step process.
- Act as point of contact for patients and families involved in patients’ care team through any form of agreed-upon communication.
- Support patients in the development of health care goals by conducting appropriate assessments that uncover comprehensive physical, mental, social and Community Supports’ needs.
- Visit patients in their homes or where they seek care, or prefer to access services in their community using and completing patient interviews on health condition knowledge and motivation to engage in self-management.
- Identify and initiate referrals for social service programs, such as financial, community and state supportive services alleviating housing instability and other social determinants of health.
- Work with ECM RN Clinical Consultant to monitor medication adherence to include medication management and reconciliation periodically for changes, especially at time of care transitions.
- Perform population management tasks such as appointment scheduling, prevention and screening recalls, monitoring referrals, patient portal callbacks and responding to telephone messages.
Requirements
- Minimum Two years’ experience in a healthcare setting, preferably providing direct patient care, or with duties involving patient education and advocacy.
- Resourceful community liaison experience navigating through complex health systems and community services.
- Bilingual English/Spanish
- Valid CA driver’s license and vehicle insurance, reliable transportation; minimum two years’ driving experience; no more than two violations or a single ticket/accident valued at more than one point on driving record.
Qualifications
- Experience working with patients with a serious mental illness and/or substance use disorder.
Skills
- Evidence-based motivational interviewing techniques
- Trauma-informed care language
- Medication management and reconciliation
Benefits
- Competitive Compensation & Benefits
- Medical, dental, vision
- Company-paid life insurance
- Flexible spending accounts
- 403(b) retirement plan
Pay
$23.00 - $25.00 Depending On Experience