Position Overview: The Lead Care Manager facilitates direct outreach in the community by visiting community hubs to build relationships and nurture trust and safe spaces. Collaborates with community partners on targeted outreach to the most vulnerable communities. Attend community stakeholder groups, community events, vendor events and spread the word about ECM programming, resources and opportunities for wellness. Develops care plan with clients and refers to resources/linkages. Collaborates with the multi-disciplinary team of Clinical Consultants, and Community Health Workers. Documents outreach and any direct client contact in the electronic health records system and the cross-sector collaboration software Unite Us.

Salary Range: W2 Employee at Compensation Salary (PTE) $25-$35 per hour. Some LCM staff may be (FTE) and include health insurance benefits.

Position Summary: The Lead Care Manager operates as the primary case manager of TPF’s multidisciplinary care team. Coordinating care involves being responsible for providing and organizing the assignment of direct services to clients. The Lead Care Manager also assist clients in scheduling and confirming appointments, onboarding to the program, arranging transportation to appointments and sending reminders prior to a client’s appointment. Manages the sharing of client information needed for consultations and identifies resources that would empower wellness. Consults with complete Care Team and utilizes established care plan to track progress and and in some cases regression of goals that were set in the client's care plan. Helps Care Team identify new resources and offers linkages/resources and collaborative care ongoing. Documents all contacts with clients and follows ECM protocols. Helps with outreach and recruitment from community meetings and events. Position requires a minimum schedule commitment of 12 hours per week for direct service provision. Direct service provision includes ECM outreach, assigned meetings, and community event/outreach facilitation. For PTE staff, shifts can be a max of 30 hours per week. FTE shifts can be requested and approved by the Executive Director.

Duties and Responsibilities:

• Be available to service at least 2 cohort of clients (cohorts are made up of groups of 10-20 clients for LCMs) and contact them approximately two-five times per month with supportive care management either in person, in community, or virtually. Will document for all attempts as well as successful contacts in EHR system.
• Support with onboarding prospective ECM clients; will explore with client needs via an in-depth review of current functioning, including discussion of recommendations from Blueprint Health Diagnostic Screener to determine if a clinical program tract should be assigned in addition to care management.
• Will support the client in developing a care plan that includes treatment planning with goals and objectives and ensuring the client is completing behavioral assessments and tracking progress and regression or need for resources in collaboration with a , as needed.
• Learn and utilize EHR systems to document and support care planning, goal tracking and resource provision.
• Will utilize a cross referral system (Unite Us, Find Help) to close the loop on a referral and ensure that clients referred out have a continuum of care.
• Support prospective clients in completing ECM Enrollment forms and initial assessments. Ensure clients move from prospective to enrolled in ECM.
• Attend mandatory Outreach Team meetings with the Outreach Team and also any supervisory meetings recommended with assigned Team Lead.
• Attend mandatory monthly staff meetings
• Attain a solid understanding of TPF programs to be able to communicate effectively about programming.
• Conduct at least one support group or workshop related to topics around mental health, wellness, health promotion, or education. TPF requires one support group or workshop is scheduled in EHR per month for each cohort member assigned as clients.
• Support with offering clinical consultation to the ECM clients and Outreach and Advocacy as needed (appropriate if LCM holds a mental health related degree)
• Support with special events, workshops and outreach as assigned.
• Work as part of a multidisciplinary team to provide quality care to clientele, ensuring safety and best practices to ensure care plans are established, goals set and met.
• Communicate and effectively interact with all clinical and non-clinical staff coordinating care for clients. Act as a team player in the collaborative process.
• Complete assigned contacts to clients within a 30 day period and document within 48 hours every attempt or successful contact of client’s provided monthly.
• Complete Training Academy and completion certificate.
• Meets deadlines and requirements and performs ethically.
• Supports team of Clinical Consultants, Community Health Workers, Licensed Clinical Consultants, and Interns.
• Support with safety planning, clinical support, as needed.
• Meets deadlines and requirements. , and performing ethically.
• Assist with outreach, recruitment and /enrollment.
• Provide outreach services and at in person events at TPF wellness center, at virtually events, and/ or in person community events.
• Work as part of a multidisciplinary team to provide quality care to clientele, ensuring safety and best practices to ensure care plans are established, goals set and met.
• Communicate and effectively interact with all clinical and non-clinical staff coordinating care for clients.
• Submits and ensures the team submits documentation within 48 business hours of services.
• Additional duties as assigned and agreed upon by both parties.

Experience:

• Peer Outreach Experience and/or Peer-Led Mental Health Trainings/Certification.
• At least one year of Special Events/Community Outreach experience.
• Passion for the community and service to others.
• Ability to support a client in accessing resources, may include some crisis intervention and consultation with clinical consultants.
• Ability to document professionally.
• Ability to communicate effectively about ECM programming.
• Tech savvy - proficient in computers, phone, email, slack.
• Experience with building relationships and collaborating with others in a work setting.
• One plus years of case management or customer service experience.

Benefits:

• Opportunity to work with a dedicated and passionate team.
• Chance to make a difference in the lives of children and families.
• Nonprofit employment may qualify for loan forgiveness programs with the Department of Education depending of amount of hours worked weekly.
• $500 yearly training reimbursement once past probationary period.

The Lead Care Manager position is a great opportunity for a motivated and organized individual who is looking to gain experience in a fast-paced and dynamic environment. The ideal candidate will be able to work independently and as part of a team, and will have a strong commitment to providing excellent customer service. Submit your resume and cover letter to .

Job Types: Full-time, Part-time

Pay: $52,000.00 - $72,800.00 per year

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid sick time
• Parental leave
• Vision insurance

Schedule:

• 8 hour shift

Experience:

• Nursing: 1 year (Preferred)
• Case management: 1 year (Required)

License/Certification:

• RN (Preferred)

Ability to Commute:

• Pasadena, CA 91103 (Required)

Ability to Relocate:

• Pasadena, CA 91103: Relocate before starting work (Preferred)

Willingness to travel:

• 25% (Preferred)

Work Location: In person