Qualifications: Bachelor’s degree (preferred) in social work, criminology, sociology, child development or related field, or year-for-year experience working with at-risk and/or their families, including 3 yrs. Case Management experience preferred.
Must have and maintain CA Driver’s License with reliable transportation and may require specific car insurance requirements
Background Clearance Requirement: Employment will be contingent on successfully passing a mandatory background check through Fresno County Probation. This will be completed, passed and clearance will be maintained according to the satisfaction of Probation. An outside background clearance will not be accepted or considered.
Experience: The position requires experience coordinating supportive services, maintaining accurate case management documentation, monitoring participant progress, and tracking outcomes in accordance with organizational and grant requirements. Candidates should possess strong organizational, communication, and interpersonal skills, with the ability to work effectively as part of a multidisciplinary team while managing multiple priorities. Experience utilizing electronic case management systems, Exym software, and Microsoft Office applications is preferred. A commitment to trauma-informed, culturally responsive, and strengths-based practices is essential, along with a demonstrated ability to empower individuals to achieve meaningful employment and long-term career success.
Supervision: The Cal-AIM Case Manager reports to the Director of Programs and Care Integration.
Description of Duties and Responsibilities: The CalAIM Enhanced Care Management (ECM) Case Manager provides comprehensive, person-centered, community-based care coordination to Medi-Cal members with complex medical, behavioral health, and social needs. Working within California's CalAIM initiative, the Case Manager serves as the primary point of contact for assigned members, coordinating healthcare, behavioral health, housing, and community-based services to improve health outcomes, reduce unnecessary hospital utilization, and promote long-term stability and self-sufficiency. This position utilizes a trauma-informed, strengths-based, culturally responsive, and client-centered approach while collaborating with interdisciplinary care teams, managed care plans, healthcare providers, and community organizations.
Major Responsibilities:
- Conduct comprehensive biopsychosocial assessments to identify members' needs in the areas of physical health; mental health; SUD; oral health; trauma- informed care; social supports; housing; vocational/employment; wellness; and referral and linkage to community-based services and supports.
- Develop, implement, and regularly update individualized care plans in collaboration with members, families, healthcare providers, and interdisciplinary care teams.
- Provide intensive care coordination for members enrolled in CalAIM Enhanced Care Management (ECM).
- Conduct community-based outreach, including home visits, hospital visits, shelters, schools, and other community settings, to engage members and reduce barriers to care
- Coordinate medical, behavioral health, substance use treatment, pharmacy, specialty care, and social service referrals.
- Assist members in accessing CalAIM Community Supports, including housing navigation, housing tenancy services, medically tailored meals, transportation, recuperative care, respite services, and other eligible benefits.
- Collaborate with primary care providers, behavioral health clinicians, hospitals, managed care plans, schools, probation departments, child welfare agencies, and community-based organizations to ensure continuity of care.
- Utilize evidence-based practices, such as Motivational Interviewing, Harm Reduction Techniques, and Trauma- Informed Care principles.
- Conduct outreach and engagement activities to facilitate linkage to the ECM program. Outreach and Engagement consists of phone calls, mailed information, and field visits.
- Monitor member progress through regular follow-up contacts, reassessments, and care plan updates.
- Maintain accurate, timely, and compliant documentation in electronic health records and case management systems.
- Maintains and updates Focus Forward database making changes, additions, and deletions as needed.
- Flexibility regarding schedule (evenings and weekends are required and based on program needs)
- Attend relevant training, workshops, and community meetings and events.
- Attend collaborative meetings and training courses as needed.
Specific/Additional Duties:
- Be responsive, consistent, and reliable with all clients, staff, and partners.
- Maintain up-to-date, well-organized, and accurate case files, records, and databases.
- Ability to report out on all assessments and case management updates, challenges, or concerns.
- Ensure compliance with HIPAA, confidentiality regulations, Medi-Cal documentation standards, and CalAIM program requirements.
- Participate in ongoing professional development and required CalAIM training.
- All other duties as assigned
Required Knowledge/Skills:
- Understanding of Medi-Cal, managed care systems, healthcare navigation, and social determinants of health.
- Able to effectively communicate the benefits or program enrollment
- Excellent verbal and written communication skills and organizational skills
- Demonstrated computer skills including, but not limited to using databases, use of Microsoft Office, Social Media, Website and Email
- Knowledge of CalAIM Enhanced Care Management (ECM) and Community Supports programs.
- Ability to conduct comprehensive assessments and develop individualized care plans.
- Demonstrated Customer Service Skills
- Ability to develop and maintain professional working relationships with management, co-workers, partners, and the public.
- Ability to work under pressure and handle multiple tasks simultaneously.
- Knowledge of available resources within the community for the client population
- Ability to work with youth, young adults and families who face multiple risk factors, barriers and have had justice and/or child welfare involvement
- Ability to think critically and identify opportunities, challenges, needs and prioritization of work to meet mandatory outcomes of program and organization
- Must exercise good judgment and have experience working on projects with specific goals and outcome measurements
- Must be organized and be able to connect program and client needs to other services, may need to think ‘outside the box’ and brainstorm with staff and partners to fully meet client and family needs
- Interpersonal savvy, demonstrated by the ability to interact with and influence people to establish trust and build strong relationships
- Ability to do home visits and outreach
- Have a basic understanding of the child welfare and justice systems and ability to learn to navigate both systems on behalf of youth
- Bi-lingual a plus
Work Environment and Physical Conditions/Demands:
Cubicle setting, sitting/standing for prolonged periods of time, lifting to approximately 40 pounds (more or less as needed), some meetings and appointments or presentations offsite in the community, heavy computer and telephone usage, physical coordination, working in noisy or crowded environment, speak loudly, stopping, bending, lifting, reaching, must drive vehicle. Must be comfortable interacting with clients facing various challenges and provide services in a non-judgmental manner. These conditions and physical demands are representative of those that must be met by an employee to successfully perform essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.
Compensation: $24hourly and benefits package that includes a portion of medical insurance coverage, 100% of dental coverage (employee + 1 dependent), 100% of vision coverage (employee only) and 403b retirement option with up to 4% employer match. Mileage reimbursement for approved work-related travel at the federal reimbursement rate. Paid holidays, sick time off, and paid time off upon supervisor approval.
If you are interested in applying, please send your resume and cover letter to Marc Salazar at .
Position open until filled.
Pay: From $24.00 per hour
Benefits:
- 403(b) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
