ECM Lead Care Manager

ECM Lead Care Manager 36977 Park Avenue, Burney, CA 96013 $21.76 - $31.43 an hour - Full-time $21.76 - $31.43 an hour -

Full-time Job Summary:

The ECM Lead Care Manager's primary focus in managing whole person care for ECM patient case management. This includes facilitating access to a broad range of services including primary care, behavioral health, substance use treatment, housing support, and social services. Ensure management of services that are in alignment with CalAIM goals and Partnership HealthPlan of California (PHC) contractual requirements. The ECM Lead Care Manager reports directly to the ECM Supervisor.

Responsibilities:

1. Complete initial and ongoing assessments to identify members' medical, behavioral health, and social needs, including housing, food security, transportation, and support systems. 2. Collaborate with members, families, and multidisciplinary teams to create and regularly update care plans that reflect the member's goals, preferences, and cultural values. 3. Facilitate access to a broad range of services including primary care, behavioral health, substance use treatment, housing support, and social services to ensure integrated care delivery. 4. Act as the lead coordinator for all care team members, including health care providers, social workers, housing specialists, and other support personnel. 5. Identify barriers to care and advocate on behalf of members to address gaps in services, obtain necessary authorizations, and reduce health disparities. 6. Employ motivational interviewing, trauma-informed care, and culturally sensitive strategies to build trust and engage members who are historically underserved or disconnected from traditional systems. 7. Educate members about their conditions, medications, and care options; empower them to make informed decisions and increase their health literacy. 8. Meet members in community settings (e.g., shelters, encampments, hospitals, or homes) to assess needs, monitor progress, and deliver support where they are most comfortable. 9. Track and report member progress toward care plan goals; document all encounters and interventions accurately and timely in the electronic health record (EHR) system. 10. Coordinate hospital discharges, transfers, or changes in care setting to promote continuity of care and prevent avoidable readmissions or service disruptions. 11. Build and maintain effective working relationships with local service providers, including housing agencies, behavioral health clinics, and public benefit programs. 12. Adhere to CalAIM ECM policies, procedures, and reporting requirements; participate in training and quality improvement activities as required. 13. Assists providers with paperwork and collection of records needed to ensure quality patient visits. 14. Participates in the Case Management meetings with relevant departments. 15. Maintains patient confidentiality at all times; abides by HIPPA and other regulations put forth by the various regulatory agencies. 16. Performs other duties as assigned by the supervisor related with the general ambit of Lead Care Manager.

Requirements :

1. High school diploma or equivalent. 2. Minimum 3-5 years of experience in care management or care coordination. 3. Experience working with individuals experiencing homelessness, serious mental illness, substance use disorder, or other complex health and social needs. 4. Knowledge of CalAIM ECM program goals, requirements, and workflows. 5. Strong organizational and leadership skills with the ability to coordinate across departments. 6. Excellent written and verbal communication skills, including team facilitation. 7. Proficiency in electronic health records (EHR), data tracking, documentation, and reporting. 8. Ability to manage multiple priorities and meet deadlines. 9. Knowledge of local community resources and service systems. 10. Cultural competency, particularly with Native American communities. 11. Ability to work both independently and as part of a collaborative team. 12. Valid driver's license, clean driving record, and willingness to travel as needed. 13. Ability to pass a pre-employment drug screening. 14. Must meet Indian preference requirements in accordance with

P.L. 93-638.

Pay:

$21.76 - $31.43 per hour

Benefits:

Dental insurance Health insurance Paid time off Retirement plan Vision insurance

Work Location:

In person