Community Support Lead Care Manager

Pacific Health GroupSanta Clara, CA
5d$27 - $30Hybrid

About The Position

At Pacific Health Group (PHG), we are at the forefront of revolutionizing health and wellness, setting new benchmarks in healthcare services 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 is designed to help Medi-Cal members live more independently in the community by addressing their health-related social needs. As a Community Supports Lead Case Manager, you won’t just create care plans; you’ll personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way.

Requirements

  • Experience: 3–5 years in case management, social services, or healthcare.
  • Expertise: Familiarity with Medi-Cal, CalAIM, and Community Supports programs.
  • Healthcare Insight: Knowledge of healthcare systems, managed care operations, and local community resources.
  • Interpersonal Skills: Strong communication, empathy, cultural competence, and teamwork.
  • Organizational Skills: Proven time management and attention to detail.
  • Technical Proficiency: Competence in using case management software, EHR systems, and related tools.

Responsibilities

  • Member Outreach: Conduct comprehensive evaluations of members’ needs, preferences, and eligibility through detailed conversations and data review. Develop tailored care plans based on individual health and social circumstances.
  • Comprehensive Care Coordination: Arrange all aspects of member care, including scheduling appointments, organizing follow-up services, and linking members to community resources. Ensure members receive consistent, end-to-end support for long-term stability and health improvement.
  • Case Management with a Heart: Perform empathetic assessments that capture members’ lived experiences and goals, not just medical data. Maintain close communication with members via phone, video, or in-person visits to monitor progress and address emerging challenges.
  • Resource Management: Serve as a bridge between members and available community resources, such as housing programs, workforce training, childcare, and food assistance.
  • Patient Advocacy: Advocate for timely treatments, fair insurance authorizations, and equitable access to care.
  • Communication & Collaboration: Act as the central communication hub among members, their families, healthcare providers, and community partners.
  • Documentation: Maintain accurate, up-to-date documentation of assessments, care plans, progress notes, and outcomes. Ensure all records comply with legal, ethical, and organizational standards for quality and accountability.
  • Continuous Improvement: Collect and analyze feedback to identify gaps in care coordination and advocate for new resources or partnerships.
  • Regulatory Compliance: Remain current on Medi-Cal, CalAIM, and community support policies to ensure all activities meet compliance and quality-of-care standards.
  • Professional Development: Participate in workshops, training, and certifications on cultural competence, trauma-informed care, and motivational interviewing. Encourage peer learning and continuous growth within the care team.
  • Leadership & Team Support: Provide mentorship, guidance, and day-to-day support to other Care Managers within the Community Supports Program. Assist in onboarding new team members and promoting a collaborative, compassionate care environment.
  • Other Duties: Support program initiatives and special projects as assigned. Demonstrate flexibility and teamwork to ensure departmental success.
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