ECM Lead Care Manager

Job Summary

The official job title is Lead Care Manager (LCM). The LCM role involves developing personalized care plans, coordinating member services, and collaborating closely with members and families, as well as Primary Care Providers to ensure they receive necessary medical treatment and support.

Responsibilities

• Interview members to assess medical and social determinant of healthcare gaps and provide education about their condition and medication, while developing individualized care plans.
• Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.
• Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
• Maintain ongoing contact with members, via telehealth and in-person visitation.
• Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.
• Support behavioral health coordination, Substance Abuse and Community Resources.
• Perform additional duties as assigned.

Populations of Focus

• Individuals experiencing homelessness
• Individuals at risk for avoidable hospital or emergency department utilization
• Individuals with Serious Mental Health and/or substance use disorder needs
• Individuals transitioning from incarceration/Justice Involved
• Adults living in the community and at risk for long-term care institutionalization
• Adult nursing facility residents transitioning to the community
• Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with Additional Needs Beyond the CCS condition
• Children and Youth Involved in Child Welfare
• Individuals with Intellectual/Developmental Disabilities
• Pregnant and Postpartum individuals; Birth Equity Population of Focus

Education and Experience

• High school diploma or GED required.
• Minimum of 1 year experience in case management, member care, customer service, call center, or member care required.
• Valid California driver's license and valid vehicle insurance required.
• MA certificate or medical terminology knowledge preferred.

Required Skills/Abilities

• Excellent communication, interpersonal, customer service and organizational skills.
• Computer skills for documentation, email and chat support.
• Proficient skills in working independently and collaboratively in a team to provide member care.
• Proficiency in multitasking, organization, and attention to detail is required for effectively providing care to multiple members simultaneously.
• Candidates should exhibit the capability to utilize resources effectively for problem-solving while maintaining composure under pressure in a compassionate manner.
• Applicants must demonstrate proficient speaking, reading, and typing abilities and possess strong proofreading skills.

Physical Requirements

• Must be able to travel using personal vehicle to complete outreach visits.
• Mileage reimbursement for the use of your vehicle is at a standard rate.
• Must successfully complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.
• Prolonged periods of sitting at an office desk on the computer.
• Lifting: Able to lift up to 15lbs.

Pay Range

$25 USD - $28 USD