Lead Care Manager
Department: Enhanced Care Management (ECM) Reports To: ECM Director FLSA Status: Non-Exempt
Position Summary
The Lead Care Manager is responsible for providing comprehensive Enhanced Care Management (ECM) services while serving as a leader within the care management team. This position ensures members receive high-quality, person-centered care through care coordination, resource linkage, advocacy, and collaboration with interdisciplinary providers.
In addition to managing an assigned caseload, the Lead Care Manager supports the growth and operational success of the ECM program by participating in outreach and enrollment activities, mentoring team members, assisting with quality improvement initiatives, maintaining regulatory compliance, and completing special projects as assigned by the ECM Director. This position requires flexibility, professionalism, strong organizational skills, and a commitment to supporting departmental goals during periods of program growth and staffing changes.
Essential Duties and Responsibilities
Member Care Management
- Manage and maintain an assigned ECM member caseload in accordance with DHCS and health plan requirements.
- Complete comprehensive assessments, care plans, progress notes, and documentation within required timeframes.
- Coordinate medical, behavioral health, social service, housing, transportation, and community resources to address member needs.
- Conduct telephonic, virtual, office-based, and field-based outreach when appropriate.
- Monitor member progress and revise care plans based on changing needs.
- Advocate for members to reduce barriers to care and improve health outcomes.
Leadership Responsibilities
- Demonstrate flexibility by performing cross-functional responsibilities to ensure continuity of services.Documentation & Compliance Maintain timely, accurate, and complete documentation in PointClickCare and other required systems. Ensure all documentation meets DHCS, Managed Care Plan, and organizational standards. Protect member confidentiality and comply with HIPAA regulations. Maintain required certifications, trainings, and continuing education.Additional ResponsibilitiesThe Lead Care Manager is expected to demonstrate flexibility and teamwork. Duties may be temporarily adjusted based on business needs, staffing levels, program expansion, regulatory changes, or organizational priorities.Responsibilities may include, but are not limited to: Supporting outreach and enrollment initiatives. Assisting with community engagement activities. Completing documentation audits. Training or mentoring staff. Developing workflows, policies, or educational materials. Participating in quality improvement initiatives. Assisting with emergency operational coverage. Completing additional assignments as directed by the ECM Director.
- Minimum Qualifications Bachelor’s degree in Social Work, Psychology, Human Services, Public Health, Nursing, or related field preferred. Minimum two (2) years of care management, case management, or care coordination experience. Experience working with high-risk populations preferred. Knowledge of Enhanced Care Management (ECM), CalAIM, Medi-Cal, and community resources preferred. Valid California Driver’s License and reliable transportation. CPR/First Aid Certification (or ability to obtain upon hire). Ability to pass background clearance and all employment screenings.Preferred Qualifications Bilingual (English/Spanish) strongly preferred. Experience with PointClickCare or other Electronic Health Record systems. Leadership or supervisory experience preferred. Experience with community outreach and networking.Required Skills Excellent verbal and written communication. Strong organizational and time management skills. Critical thinking and problem-solving. Ability to work independently while collaborating with a multidisciplinary team.
- Ability to prioritize competing responsibilities. Professional conflict resolution skills.
Strong documentation and computer proficiency. Ability to adapt to changing program needs.Performance ExpectationsLead Care Managers are expected to: Maintain timely documentation with minimal corrections. Meet established productivity standards. Demonstrate professionalism and accountability. Provide exceptional member-centered care. Support department initiatives and organizational growth. Participate in outreach and enrollment efforts when assigned. Complete projects and assignments by established deadlines. Maintain compliance with all DHCS, health plan, and organizational requirements. Demonstrate flexibility by assisting with operational needs as directed by the ECM Director.
Job Type: Full-time
Pay: $23.00 - $25.00 per hour
Experience:
- Case management: 1 year (Required)
Work Location: In person
