Lead Enhanced Care Manager

Description

Job Summary:

This position serves as a lead-level resource for assigned programs by providing operational support, assisting with staff oversight, monitoring program performance, and ensuring high-quality Enhanced Care Management (ECM) services are delivered in accordance with organizational, contractual, and regulatory requirements

Essential Functions:

Program Operations and Leadership

• Oversee and support the day-to-day operations of assigned programs, ensuring services are delivered effectively and in alignment with program goals, grant requirements, contractual obligations, and EPU standards.
• Assist with the supervision, training, coaching, and mentoring of assigned staff to promote quality service delivery and professional development.
• Serve as the primary point of contact for assigned programs and represent the department in the absence of the Manager or Director, as designated.
• Coordinate staffing and service delivery schedules to ensure continuity of services during staff absences, vacancies, and changing program needs.
• Monitor program operations and service quality to ensure compliance with organizational policies, funding requirements, and applicable regulations.
• Collect, track, analyze, summarize, and report program data, outcomes, and performance measures required by funding sources, organizational leadership, and program objectives.
• Ensure assigned staff conduct required home visits and maintain regular contact with families as outlined in care plans, program standards, and contractual requirements.
• Assist in identifying operational challenges and implementing solutions to improve program efficiency, effectiveness, and participant outcomes.

Enhanced Care Management (ECM) Service Delivery

• Maintain and manage an assigned ECM caseload, as needed, ensuring timely and effective service delivery.
• Engage eligible members and coordinate services with individuals, providers, agencies, and community partners to ensure a seamless member experience and avoid duplication of services.
• Support the Supervisor in overseeing the delivery of ECM services and implementation of individualized care plans.
• Deliver services in locations most accessible and appropriate for members, including where they live, seek care, or otherwise receive services, in accordance with health plan requirements.
• Connect members to community resources, social services, transportation, and community supports that address identified needs.
• Advocate on behalf of members with healthcare providers and other service systems to improve access to care and resources.
• Coordinate with hospitals, healthcare providers, and community partners regarding discharge planning, treatment adherence, medication management, and continuity of care.
• Utilize motivational interviewing, trauma-informed care, and harm-reduction approaches when engaging with members and their support systems.
• Accompany members to appointments, when appropriate and permitted under health plan guidelines.
• Provide health education, health promotion, self-management support, and coaching to assist members in achieving their health and wellness goals.
• Maintain accurate, timely, and complete documentation, including case notes, assessments, care plans, and service activities in Apricot or other designated data systems in accordance with established protocols and regulatory requirements.
• Ability to follow detailed procedures, prioritize competing tasks, and complete documentation accurately and on time.
• Be familiar with EPU policies and procedures and maintain proper confidentiality.
• Maintain, manage, and process client records and information in a confidential manner that meets HIPAA and other applicable confidentiality regulations.
• The position requires the ability to meet with children/families in various locations in the community. To meet this expectation staff are required to provide reliable transportation for travel for business purposes. Hold a valid California Driver's license. Possess a good driving record with no serious violation for the past three-year period and be able to provide proof of current automobile liability insurance that meets the minimum standard that meets the State of California requirements.
• EPU facility hours are Monday – Friday; 8:00 AM – 6:00 PM; with some exceptions based on business needs. Positions hours may vary depending upon the needs of the business.
• Perform other duties as they are assigned by the Sr. Manager, Program Director, and/or President/Chief Executive Officer.

Requirements

Knowledge and Skills

Strong communication skills, both written and verbal, able to make independent decisions when handling sensitive family and child information, within guidelines. Strong problem-solving, critical thinking, and decision-making skills. 

Experience

• 2+ years of experience providing direct services to children, families, or vulnerable populations.
• 2+ years of experience working with families impacted by, or at risk for, abuse, neglect, trauma, or other significant social challenges.
• 2+ years of case management or care coordination experience, including connecting individuals and families to community resources and support services.
• 1+ years’ experience in case management principles, care coordination practices, family support services, and community resources
• 1+ years of experience in a supervisory, lead worker, or staff oversight experience.
• 1+ years of experience working with diverse populations and demonstrating cultural responsiveness when providing services.
• 1+ years of experience engaging families in problem-solving, advocacy, resource coordination, and goal achievement.
• Experience in gathering, analyze, summarize, and communicate information accurately and effectively.
• Bilingual in English and Spanish or English and Hmong.
• Experience working in Enhanced Care Management (ECM), CalAIM, Medi-Cal Managed Care, social services, behavioral health, or related health and human services programs.
• Experience using Apricot or other electronic case management or data-tracking systems.
• Must be computer literate with experience in maintaining accurate records, entering data, and documenting services within an electronic database or case management system. Working with Microsoft Office applications, including Word, Excel, Outlook, and Teams.

Licenses and Other Requirements

Hold a valid California Driver's license. Possess a good driving record with no serious violation for the past three-year period and be able to provide proof of current automobile liability insurance that meets the minimum standard that meets the State of California requirements. Reliable transportation and the ability to travel throughout the service area to conduct home visits, attend meetings, and provide community-based services.

Physical Demands:

Typical Working Condition: Staff must visit families in their homes. EPU does not have control over the location and condition of all the environments staff may be exposed.  

Equipment Used: Personal vehicle for local travel, computers, printers, telephones, and fax machines.

Essential Physical Tasks: Working with children and their families may require the ability to sit on floors, stand, stoop, crawl, lift, carry, push, and pull.

This position description may not be an exhaustive list of all duties, knowledge, or abilities associated with this classification; however, it is intended to accurately reflect the principle job elements. Related duties, knowledge, or abilities to those expressly stated may also be required for successful performance of the position.