About The Position

At Pacific Health Group, we are at the forefront of revolutionizing health and wellness through innovation, compassion, and community-driven care. Our mission is to empower members, uplift families, and positively impact the communities we serve. Our Community Supports (CS) Program helps Medi-Cal members live more independently by addressing health-related social needs. In this role, you won’t just create care plans—you’ll guide members through every step of their journey, ensuring they receive the support and services needed to thrive. This is a highly field-based role supporting members directly in the community. You will manage a caseload of members with complex health and social needs, spending approximately 65% of your time in the field (homes, shelters, community settings). This includes conducting in-person visits, assessments, and follow-ups, and traveling locally within Santa Clara County. You will coordinate services across healthcare, behavioral health, and community resources, and participate in community outreach efforts including events, partnerships, and local engagement. The role also involves providing mentorship and support to other care managers and documenting in real-time or by end of day using internal systems. This position requires independence, strong time management, leadership capability, and comfort working in fast-paced, community-based environments.

Requirements

  • 3–5 years in case management, social services, or healthcare
  • Strong understanding of healthcare systems, managed care, and community resources
  • Excellent communication, empathy, and cultural competence
  • Strong organizational and time management skills
  • Must be proficient in technology, including case management systems, EHR platforms, and documentation tools
  • Ability to document in real-time and manage member data accurately
  • Comfortable navigating multiple systems and communication platforms
  • Ability to travel locally within Santa Clara County
  • Valid California Driver’s License and reliable transportation
  • Ability to work in a hybrid, field-based environment

Nice To Haves

  • Experience with: Medi-Cal, CalAIM, and Community Supports programs (preferred)

Responsibilities

  • Conduct comprehensive member assessments to identify health and social needs
  • Develop and manage individualized care plans
  • Coordinate appointments, services, and long-term support systems
  • Ensure continuity of care and consistent follow-through
  • Build strong, trusting relationships with members and their families
  • Provide ongoing support through phone, video, and in-person visits
  • Advocate for timely care, services, and equitable access to resources
  • Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives
  • Build and maintain relationships with community-based organizations, shelters, and service providers
  • Identify opportunities to expand community presence and improve access to services
  • Support outreach efforts that drive member engagement and program awareness
  • Connect members to housing, food access, workforce programs, childcare, and other services
  • Strengthen partnerships with community-based organizations
  • Identify gaps in resources and escalate needs for program improvement
  • Provide guidance, mentorship, and support to care managers within the program
  • Assist with onboarding and training of new team members
  • Promote consistency, collaboration, and best practices across the team
  • Maintain accurate and timely documentation of all member interactions
  • Ensure compliance with Medi-Cal, CalAIM, and Community Supports program requirements
  • Track progress, outcomes, and service delivery
  • Partner with interdisciplinary teams including behavioral health, outreach, and social services
  • Coordinate with healthcare providers and payers to ensure seamless care delivery
  • Identify trends and gaps in services
  • Provide feedback to leadership to improve care coordination strategies and partnerships

Benefits

  • Hourly Range:$30.00 - $35.00, depending on experience, qualifications, and internal equity
  • Monthly stipend
  • 160 hours PTO + paid sick time
  • 11 paid holidays (including birthday and floating holiday)
  • 4 paid volunteer hours per month
  • 90% employer-paid employee-only medical benefits
  • Flexible Spending Account (FSA)
  • Short-term & long-term disability, AD&D
  • Employee Assistance Program (EAP)
  • 401(k) with company match
  • Professional development opportunities
  • Quarterly in-person events
  • Employee discount programs
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