Clinical Case Manager

About the role

We are looking for a highly skilled Clinical Lead Care Manager (CLCM) to join our team serving San Diego, CA. Reporting to the ECM Clinical Manager, the CLCM acts as the client's primary point of contact, partnering with healthcare providers and support services to ensure coordinated, aligned, and comprehensive care. The CLCM manages client cases, coordinates health care benefits, provides education and facilitates member access to care in a timely and cost-effective manner. The CLCM collaborates and communicates with the client's caregivers/family support persons, other providers, and others in the Care Team to promote wellness, recovery, independence, resilience, and member empowerment, while ensuring access to appropriate services and maximizing member benefit. This is a hybrid position that requires traveling throughout the San Diego area up to 5 days per week. Candidates wishing to be considered must reside within 25-miles of the assigned territory due to frequency of travel.

Responsibilities

• Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports
• Oversees the development of the client care plans and goal settings
• Offer services where the member resides, seeks care, or finds most easily accessible, including office-based, telehealth, or field-based services
• Connect clients to other social services and supports that are needed
• Advocate on behalf of the client with health care professionals (e.g. PCP, etc.)
• Utilize evidence-based practices, such as Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles
• Conduct outreach and engagement activities in order to facilitate linkage to the ECM program and log activity in the Client Relationship Management (CRM) system
• Evaluate client's progress and update SMART goals
• Provide mental health promotion
• Arrange transportation (e.g., ACCESS)
• Complete all documentation, including outcome measures within the timeframes established by the individual care plans
• Maintain up-to-date patient health records in the Electronic Medical Record (EMR) system and other business systems
• Complete monthly reporting to ensure program compliance
• Attend training as assigned

Requirements

• Active California Licensed Vocational Nurse (LVN) license required
• Willing and able to work Monday-Friday 8:30am-5:00pm, both in the field and remotely
• 2+ years of experience as a care manager, care navigator, or community health worker supporting vulnerable populations
• Working knowledge of government and community resources related to social determinants of health
• Excellent oral and written communication skills
• Positive interpersonal skills required
• Valid driver's license, and reliable transportation
• Must have general computer skills and a working knowledge of Google Workspace, MS Office, and the internet

Qualifications

• Bilingual, Spanish/English, preferred