Director Of Enhanced Care Management

Gracelight Community Health•Los Angeles, CA

11d

About The Position

The Director of Enhanced Care Management (ECM) will lead the strategic development, operational oversight, and continuous improvement of Gracelight Community Health's (Gracelight) Enhanced Care Management program. This pivotal role is responsible for directing the comprehensive ECM program across all fixed sites and expanding service delivery models, including new mobile units. The Director will ensure program fidelity, regulatory compliance (especially with CalAIM/Medi-Cal ECM requirements), and the achievement of critical patient outcome and encounter targets as part of Gracelight's strategic plan. This position requires a strong leader with expertise in care management, population health, operational efficiency, and a deep commitment to serving diverse and vulnerable communities.

Requirements

Master’s degree in public health, Social Work, Nursing, Healthcare Administration, or a related field or relevant experience.
Minimum of 5-7 years of progressive leadership experience in care management, population health, or complex case management, preferably within an FQHC, community health setting, or managed care environment.
Demonstrated experience in program development, implementation, and scaling, particularly for new or revamped service lines.
In-depth knowledge and hands-on experience with CalAIM Enhanced Care Management (ECM) and Community Supports (CS) requirements, operations, and reimbursement models are essential.
Experience managing multidisciplinary teams, including clinical and non-clinical staff.
Exceptional leadership, team-building, and motivational skills.
Strong analytical and problem-solving abilities, with experience using data to drive program improvement.
Excellent written and verbal communication skills, including presentation and negotiation abilities.
Demonstrated ability to build and maintain effective internal and external partnerships.
Proficiency in Electronic Health Records (EHRs) and other healthcare technology platforms.
Cultural humility and a deep understanding of the social determinants of health affecting underserved populations.
The ability to manage multiple priorities in a dynamic, fast-paced environment.
Must be able to meet and receive a criminal records clearance, as required by Title XXII, other licensing regulations, and Gracelight practices.
This position requires frequent driving. A valid California driver license, reliable personal vehicle, current personal auto insurance as required by law, and an MVR sufficient to obtain and reasonably maintain insurability under agency auto liability policies are all essential job requirements.
A personal cell phone with reliable service and, if applicable, a data plan to use for business purposes.
May be required to obtain and maintain First Aid and CPR certification.

Nice To Haves

Clinical license (RN, LCSW, LMFT) strongly preferred.
Project Management certification (e.g., PMP) or equivalent experience.
Bilingual (English/Spanish) proficiency.
Experience with mobile health or community-based outreach programs is highly desirable.

Responsibilities

Lead the overall strategic planning, design, and continuous improvement of Gracelight's ECM program, aligning with organizational goals, CalAIM ECM definitions, and best practices in population health.
Direct the implementation of the newly restructured ECM operating model, driving programmatic changes and ensuring smooth transition across all service delivery settings.
Develop and refine program policies, procedures, and workflows to ensure efficient, effective, and compliant delivery of ECM services across fixed sites and expanding mobile operations.
Provide strategic oversight and collaboration for the ECM portion of the Mobile Field Medicine Program, ensuring integration with broader ECM.
Stay current with all CalAIM/Medi-Cal ECM requirements, managed care plan guidelines, and relevant state/federal regulations, adapting program strategy as needed.
Oversee the day-to-day operations of the entire ECM program, including resource allocation, staffing models, and service delivery workflows to maximize efficiency and patient impact.
Drive the achievement of the ECM encounter target.
Ensure timely and accurate documentation within the Electronic Health Record (EHR) to support care coordination, service delivery, and reimbursement for all ECM encounters.
Implement and monitor key operational metrics related to caseloads, service delivery timelines, engagement rates, and resource utilization across the ECM team.
Collaborate with the Director of Operations to ensure seamless operational integration of ECM services within clinic workflows and new service delivery models (e.g., mobile units).
Recruit, train, supervise, and mentor a high-performing multidisciplinary ECM team, including Care Navigators and Care Coordinators.
Foster a collaborative, patient-centered, and results-driven team environment that prioritizes professional growth, resilience, and cultural humility.
Develop and implement ongoing training programs for ECM staff to ensure proficiency in CalAIM ECM domains, engagement strategies for complex populations, and utilization of Gracelight's systems.
Conduct regular performance evaluations, provide constructive feedback, and identify professional development opportunities for all ECM team members.
Ensure that all ECM services are delivered in full compliance with CalAIM ECM requirements, managed care plan contracts, Medi-Cal billing regulations, and Gracelight's internal policies.
Develop and implement a robust quality assurance program for ECM services, including chart audits, patient satisfaction surveys, and outcome monitoring.
Work closely with the Director of Risk & Compliance to identify and mitigate compliance risks specific to ECM service delivery and documentation.
Collaborate with the Finance team to ensure accurate and timely billing and maximize reimbursement for ECM services.
Forge strong internal partnerships with Primary Care, Behavioral Health, Dental, Patient Access, and other Gracelight departments to ensure integrated and holistic patient care pathways.
Cultivate and maintain strong relationships with external partners, including Medi-Cal Managed Care Plans, Community Based Organizations (CBOs), shelters, and social service agencies to facilitate referrals and resource coordination for ECM patients.
Represent Gracelight and the ECM program in external meetings, collaborative initiatives, and community forums.