Case Management Assistant (PHM)- Bakersfield 1.2

Universal Healthcare MSO LLC • Bakersfield, CA

72d • $19 - $24

About The Position

The Case Management Assistant (CMA) provides administrative and care coordination support to the Population Health Management (PHM) team, including Nurse Case Managers and Social Services staff. The CMA assists by conducting outreach, gathering and organizing information, coordinating appointments and referrals, documenting activities, and helping to address routine member needs. This role is member-focused, ensuring individuals receive timely communication, follow-up, and access to services and resources. The CMA supports member engagement activities such as wellness calls, enrollment outreach, and care gap closure, helping to improve the overall member experience and promote better health outcomes. The CMA requires strong interpersonal and organizational skills to communicate effectively with members, assist with referrals, and help coordinate services among providers, community resources, and internal care teams. The CMA also supports the Interdisciplinary Care Team (ICT) activities by gathering information, preparing documentation, and relaying member needs to the case management team.

Requirements

• High School diploma or GED required.
• Minimum of 3 years of experience in a healthcare or community health setting.
• Knowledge of case management processes and regulatory requirements for Medi-Cal, Medicare, and commercial programs preferred.
• Experience in a managed care environment preferred (IPA, HMO, or health plan).
• Medical Assistant or Community Health Worker certification preferred.

Responsibilities

• Work collaboratively with Nurse Case Managers and Social Services staff on care coordination, member follow-up, communication with agencies.
• Support PHM outreach activities by conducting calls for program enrollment, Health Risk Assessment (HRA) completion and other relevant questionnaires, wellness checks, and quality initiatives to help close care gaps.
• Contact members at regular intervals per their acuity level and care plan needs.
• Document all outreach, coordination activities, and member interactions in the case management system (CM System) accurately and in a timely manner, in alignment with program protocols.
• Support members experiencing transitions of care by assisting case managers with coordination of post-discharge needs, follow-up appointments, and transportation.
• Gather clinical information and assist with coordinating services such as home health care, prescriptions, durable medical equipment (DME), and social service referrals.
• Prepare and send member correspondence, as directed by case managers or in alignment with case management protocols.
• Report and escalate member concerns, variances, or changes in condition to the appropriate care team members to ensure timely intervention and coordinated follow-up.
• Assist members with appointment scheduling, transportation, referral coordination, and other care coordination needs.
• Gather clinical information from outside sources such as PCPs, specialists, hospitals, SNFs, and electronic health records, and upload them into the case management system.
• Verify member eligibility, demographics, and benefits; confirm provider assignments to ensure authorizations are linked appropriately.
• Support closed-loop referrals to community supports, housing, and social service agencies, with follow-up to confirm services were delivered.
• Participate in ICT meetings by gathering and presenting information and communicating member needs and preferences to the care team.
• May be assigned to manage a caseload of low-acuity PHM members, under the supervision of Nurse Case Managers or Social Services staff.
• Serve as an associate and resource to members, providers, staff, and external customers regarding policies, benefits, and care coordination.
• Provide administrative support, including answering phones, assisting with correspondence, filing, scanning, and maintaining department data systems.
• Receive and route incoming faxes, medical records, and other documentation to the appropriate case management staff.
• Track and log outreach attempts and results in the case management system to support reporting and follow-up.
• Conduct outreach to members to verify needs are being met and services delivered.
• May be assigned to conduct in-person meetings with members during clinic visits.
• Assist with training and orientation of new staff, as requested.
• Assist case management team with oral interpretation, as applicable.
• Attend mandatory staff and departmental meetings.
• Perform other duties as assigned.

Benefits

• Medical
• Dental
• Vision
• Paid Time Off (PTO)
• Floating Holiday
• Simple IRA Plan with a 3% Employer Contribution
• Employer Paid Life Insurance
• Employee Assistance Program

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED