Case Manager - CalOptima
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About The Position
CalAIM, a Department of Health Care Services (DHCS) initiative, aims to improve Medi-Cal recipients' quality of life and health outcomes through system reforms. It introduces Enhanced Care Management (ECM), a statewide Medi-Cal Managed Care Plan (MCP), that offers person-centered, community-based highest care management tier within the Medi-Cal MCP Population Health Management continuum. Participating members are assigned a Case Manager who will meet them wherever they are: on the street, in a shelter, in their provider's office, or at home to coordinate their health-related care and services, ensuring holistic approach to their well-being. In addition, ECM offers community-based services to address health-related social needs to help members live healthier lives and avoid more costly levels of care. Some examples include support to secure and maintain housing, access to medically tailored meals for short-term recovery, and various other community-based services. The In-Reach Case Manager I will engage individuals within 90 days of release, both in person and through telehealth, throughout the Orange County Jail systems to facilitate Care Management. Service provision in the Pre-Release period is designed to engage eligible JI populations, prepare them for their return to the community, and mitigate gaps in services and medication. In-reach Case Mangers will ensure the medical, behavioral, and social needs that are tied so closely to health--including housing and transportation -are met. The approach of providing services in the period prior to release helps to establish trusted relationships with care managers to develop a transition plan, coordinate care, and support stabilization upon reentry. Case Manager will continue to engage members on throughout their release to community through Enhanced Care Management authorization to continue to monitor goals and process towards program completion.
