The CalAIM Enhanced Care Management (ECM) and Community Supports (CS) Lead Care Manager is responsible for providing care coordination/ case management to eligible Medi-Cal members enrolled in CalAIM programs. This role involves working with a vulnerable population. Populations of focus include but are not limited to: SUD, SMI, Chronically Homeless, Foster Youth, Family Units and High Utilizers. The LCM plays a critical role in improving access to essential health services and support for these populations. Key Responsibilities: • Engagement and Documentation: • Provide weekly case management services to Members enrolled in CS/ECM services. • Connect Member's to community resources per their individualized needs and ECM/CS care plan. • Assist in formulating SMART goals, implementing the case plan, supervising progress, and making revisions as needed. • Initiate and maintain communication with other agencies and members of the care team for each Member. • Make weekly contact and monthly face-to-face visits (or as often as necessary) • Manage a caseload of 40-50 Members. • Complete timely ECM/CS assessments and care plans as well as required encounter notes. • Attend Multidisciplinary Team meetings with the site clinician. • Authorization and Eligibility: • Track Member Medi-Cal Eligibility and ECM/CS Program Authorization to ensure Member's remain up to date on enrollment. • Complete Member reauthorizations in a timely manner. • Collaboration & Communication: • Work closely with internal teams, including care coordination, case management, and customer service, to ensure cohesive service delivery. • Collaborate with external partners, including healthcare providers, community organizations, and social services agencies, to support member ECM/CS goals. • Provide regular updates to leadership on challenges and resources. • Communicate with CBO, PCPs, Behavioral Health, Property Managers, Landlords, etc. • Continuous Improvement: • Identify opportunities to enhance ECM/CS services provided to Members. • Stay informed about changes in Medi-Cal, CalAIM, and related regulations, ensuring compliance and program alignment. Qualifications: • Education & Experience: • A Bachelor's degree in healthcare administration, social work, public health, or a related field is preferred. • Minimum of 2 years of experience in healthcare outreach, care coordination, or a related role. • Experience working with Medi-Cal members or vulnerable populations is highly desirable. • Skills & Competencies: • Strong interpersonal and communication skills, with the ability to connect with diverse populations. • Excellent organizational and time management skills, with a focus on accuracy and attention to detail. • Ability to work independently and as part of a team in a fast-paced environment. • Proficient in using electronic health records (EHR) systems and other relevant software applications. • Other Requirements: • Valid driver's license and reliable transportation, as travel within the community may be required. • Bilingual skills are a plus, especially in [specific languages relevant to the community served]. • Good health and able to lift up to 30 pounds Other Duties and Responsibilities • Develop an understanding of and be familiar with all EA programs, specifically ECM and CS • Develop an understanding of Member needs for successful placement • Promote EA programs in the community and with placement resources • Have regular and ongoing contact with placement resources • Maintain a respectful and objective attitude, free from personal bias • Work cooperatively with all staff and supervisors • Willing to work any day of the week or hour of the day to meet agency placement needs • Know and monitor available vacancies throughout EA programs • Maintain record of contacts with placement workers • Maintain required training and competency qualifications as directed by agency leadership • Actively work to achieve agency enrollment needs as directed by the program leadership • Other duties and responsibilities as required by the AED(s), ED(s) or a supervisor
Job Title
Lead Care Manager