Lead Care Manager, Enhanced Care Management

Primary Responsibilities

• Oversees the development and implementation of the Individual Care Plan/Health Action Plan
• Connects clients to other social services and needed supports (e.g., community support group)
• With permission, coordinates/advocates on behalf of the client with health care professionals (e.g., PCP)
• Utilizes evidence-based practices, such as motivational interviewing, harm reduction techniques, and trauma-informed care principles
• Works collaboratively with hospital staff regarding Transitional Care Planning
• Conducts outreach and engagement activities to facilitate linkage to the ECM program
• Accompanies clients to office visits, as needed and appropriate

Qualifications

• Education and Experience: At a minimum, a bachelor’s degree from an accredited university in a related field is required. At least three years of relevant work experience is required.
• Multilingual capabilities are preferred but not required.
• Prior experience as a community health worker, peer support specialist, medical assistant, or similar role is a plus.
• Long-time residents of the community with good knowledge of its resources are preferred.
• Ability to complete training program and ongoing educational requirements as assigned.
• Experience with the usage of EMR/EHRs/Care Management software is preferred.