Lead Care Manager

Job Overview
The Lead Care Manager is a pivotal role in ECM, focusing on interdisciplinary, high-touch, and client-centered care coordination. This role involves proactive engagement across community setting utilizing evidence-based practices to address social determinants of health and various barriers to service access. The LCM is the primary member of a client’s care team who oversees the provision of ECM services, facilitating the initial comprehensive assessment, care plan development and service implementation

Responsibilities

• Complete the comprehensive assessment with each enrolled client, in order to identify their primary needs, strengths, barriers, goals.
• Develop and implement personalized care management plans for each client based on the information gathered during the assessment process. Identify key members of the client’s care team.
• Oversee the work of the identified care team to ensure provision of the care plan. Facilitates regular multidisciplinary team conference meetings.
• Overcome barrier to treatment and medication management, ensuring access to necessary health, behavioral, and social services.
• Monitor treatment adherence and support clients in achieving their health and wellness goals.
• Assist in coordinating and tracking transitional care services, including discharge planning and post-acute follow-ups.
• Engage in active collaboration with healthcare providers and establish supportive familial systems for clients.
• Maintain meticulous documentation of engagements, care plans, and service referrals in the ECM's EHR system.
• Maintain timely, accurate, and HIPAA-compliant documentation in the organization’s care management or EHR system.
• Other duties as assigned.

Expectations:

• Strong understanding ECM principles, with a focus on ethical client engagement and safety.
• Ability to lead a team of care providers to ensure each client is provided with the highest quality care management.
• Effective collaboration and coordination with the Outreach and Engagement Specialist, Intake Specialist, Peer Support Specialists/Community Health Workers, external providers and organizations, and other relevant parties.
• Utilization of trauma informed care, motivational interviewing and other best practices when engaging with clients.
• Proficient use of the EHR system and familiarity with various healthcare services.
• Proficiency in documentation and data management with an understanding of HIPAA guidelines.
• Utilization of techniques proven to increase engagement with identified focus populations.
• Utilization of motivational interviewing, harm reduction and trauma-informed approaches
• Commitment to cultural sensitivity and diverse community engagement.

Core Competencies:

• Advanced knowledge of trauma-informed care, harm-reduction, and motivational interviewing
• Clinical judgment and critical thinking in community-based settings
• Skilled in navigating complex care systems, including Medi-Cal and community resources
• Leadership in interdisciplinary team collaboration
• Strong written and verbal communication skills
• Cultural humility and the ability to engage with diverse populations respectfully and effectively
• Detail-oriented, organized, and accountable for documentation and reporting

Requirements:

• Master's degree (M.A./M.S.) in psychology, social work, public health or related field with at least 1 year of experience working with children and/or families.
• Or Bachelor's degree (B.A.) in social services or related field, with at least 2 years of experience working with children and/or families.
• Other than BA degree with 2 years direct service experience working in case management or related experience in the field.
• Proficient knowledge of: Electronic Health Record, Microsoft Word, Outlook and Excel.
• Bilingual Spanish Required (verbal and written skillset).
• Valid CA Driver's License.

Preferred Qualifications:

• Prior experience working with ECM Populations of Focus (e.g., individuals experiencing homelessness, justice involvement, serious mental illness, or complex medical needs).
• Experience supervising or guiding non-licensed or paraprofessional staff.
• Familiarity with Medi-Cal and CalAIM initiatives, ECM documentation, and quality
• improvement processes

Job Type: Part-time

Pay: $25.00 - $30.00 per hour

Expected hours: 20 – 30 per week

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Mileage reimbursement
• Paid sick time
• Parental leave

Work Location: In person

Salary : $25 - $30