Lead Care Manager

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. OCA#:037006640 EOE.

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