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Manage day-to-day ECM operations and ensure services are delivered in accordance with CalOptima Health, Medi-Cal, CalAIM, and agency requirements.
Develop a thorough working knowledge of ECM workflows, policies, documentation standards, and internal procedures, and use that understanding to guide operational decisions and improvements.
Monitor program deadlines, authorizations, enrollment and disenrollment processes, Health Needs Assessments (HNAs), Care Plans, ongoing service requirements, and other required ECM activities.
Maintain reliable systems for tracking assignments, deadlines, follow-up items, and outstanding program needs.
Coordinate ECM billing processes and work with appropriate staff to ensure timely and accurate monthly billing.
Monitor caseload distribution, member engagement, service utilization, staff productivity, and completion of required ECM activities.
Translate regulatory and payer requirements into clear, practical workflows for staff. Quality Assurance and Documentation
Lead ongoing internal ECM chart audits and quality improvement activities.
Review documentation for completeness, accuracy, timeliness, and compliance.
Identify documentation or workflow deficiencies, communicate corrective actions clearly, and verify that corrections have been completed.
Prepare the program for CalOptima Health audits and other external reviews.
Maintain strong attention to detail and independently review work products for accuracy and completeness before submission. Staff Supervision and Team Leadership
Provide regular individual operational supervision, coaching, and performance support to ECM Care Coordinators and other assigned staff.
Lead weekly ECM team meetings and facilitate effective case consultation, shared problem-solving, program updates, and team learning.
Monitor staff performance, address concerns directly, and provide corrective coaching and follow-up when needed.
Establish clear expectations while maintaining a collaborative and supportive team environment.
Build working relationships with staff through direct observation, consultation, coaching, and ongoing communication.
Delegate appropriately while maintaining accountability for follow-through and completion.
Support staff in managing complex cases while helping the team develop its own problem-solving capacity. Case Management and Program Consultation
Maintain a small ECM caseload as needed to remain connected to direct program operations.
Provide consultation on complex cases involving housing instability, healthcare access, behavioral health, social services, benefits, and other social determinants of health.
Support staff in developing and implementing member-centered Care Plans and coordinating services across systems.
Recognize the boundaries of the ECM scope of service and facilitate appropriate referrals and coordination with behavioral health, housing, medical, and community providers. Program Development and Community Partnerships
Identify and implement thoughtful opportunities to strengthen ECM workflows, service quality, referral pathways, and program performance.
Maintain and develop relationships with CalOptima Health, healthcare providers, community organizations, and other referral partners.
Participate in organizational initiatives related to CalAIM, Community Supports, behavioral health, and integrated care as appropriate.
Contribute to program growth and continuous quality improvement while maintaining the stability and integrity of core operations. What We Are Looking For The strongest candidate will combine hands-on operational management with collaborative leadership. We are particularly interested in candidates who can move comfortably between detailed program operations and higher-level problem-solving.
Strong organizational skills and reliable follow-through.
Ability to independently manage multiple priorities, deadlines, and work products.
Strong attention to detail and quality assurance.
Ability to learn and accurately apply complex payer, regulatory, and agency requirements.
Sound judgment regarding when to act independently, when to consult, and when to escalate.
Ability to receive feedback and translate it into subsequent practice.
Strong written and verbal communication.
Collaborative supervision and team facilitation skills.
Ability to build on established systems while identifying thoughtful opportunities for improvement.
Comfort working in a small, community-based organization where managers remain closely connected to day-to-day operations.
Cultural humility and ability to work effectively with multilingual, multicultural, and underserved communities. Minimum Qualifications
Bachelor's degree in Social Work, Public Health, Psychology, Human Services, Healthcare Administration, or a related field required.
Minimum three years of experience in care management, case management, healthcare, behavioral health, housing services, social services, or a related field.
Minimum two years of formal supervisory or program management experience, including responsibility for staff supervision, performance management, workflow oversight, and follow-through.
Experience working with underserved, high-need, or vulnerable populations.
Strong organizational, leadership, communication, and problem-solving skills.
Ability to manage multiple priorities, deadlines, and work products in a fast-paced environment.
Proficiency with electronic health records, data tracking systems, and Microsoft Office applications. Preferred Qualifications
Master's degree in Social Work, Public Health, Psychology, Human Services, Healthcare Administration, or a related field.
Three or more years of management experience in care management, healthcare, behavioral health, housing services, social services, or another regulated human services program.
Knowledge of CalAIM Enhanced Care Management, Community Supports, and Medi-Cal managed care programs.
Experience supervising care managers, case managers, community health workers, peer support specialists, or similar direct service staff.
Experience with compliance monitoring, quality improvement, audit preparation, and documentation review.
Experience supporting individuals with complex medical, behavioral health, housing, and social service needs.
Bilingual or multilingual abilities reflective of the communities served, including Chinese, Korean, Vietnamese, Spanish, or other languages.

Employment Details Reports to:

Clinical Director Classification:

Full-Time, Exempt Compensation:

$68,000 to $78,000 annually, depending on qualifications and experience Work location: Hybrid or onsite based on organizational need About AASCSC Founded in 1989, the Asian American Senior Citizens Service Center (AASCSC) is a community-based nonprofit organization dedicated to serving, protecting, and celebrating vulnerable elders, youth, and families throughout Orange County. Guided by the philosophy, \"Caring for elders and children as if they were our own,\" AASCSC provides culturally and linguistically responsive services that promote health, well-being, independence, and community connection. AASCSC is committed to building an inclusive workforce that reflects the communities we serve and encourages applicants from diverse backgrounds to apply.

Pay:

$68,000.00 - $78,000.00 per year

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Education:

Bachelor's (Required)

Experience:

Case management: 3 years (Required)

Supervising:

2 years (Required)

Work Location:

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Find & Apply For Healthcare Project / Program Manager Jobs in Santa Ana, California

Enhanced Care Management (ECM) Program Manager