ECM - Lead Care Program Manager - Northern Cal Residents Only

PACIFIC HEALTH GROUP•Stockton, CA

40d•$80,000 - $90,000•Hybrid

About The Position

At Pacific Health Group, we are at the forefront of revolutionizing healthcare. We are dedicated to improving health outcomes by addressing social determinants of health and coordinating comprehensive community-based services, particularly through our Enhanced Care Management (ECM) program. Our culture fosters collaboration, innovation, and a commitment to health equity. Joining our team means contributing to meaningful change for vulnerable populations while developing your professional skills in a supportive environment.

Requirements

Master’s, or Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or related field
5+ years of experience in healthcare management, with at least 3 years in care/case management services
Minimum of 2 years of direct experience working in Enhanced Care Management programs or equivalent intensive care management initiatives
Demonstrated understanding of ECM program requirements, populations of focus, and care management best practices specific to high-need Medicaid populations
Previous supervisory experience managing teams across multiple locations
Thorough understanding of care management principles and practices
Strong knowledge of healthcare delivery systems and Medicaid/Medicare programs
In-depth familiarity with California's ECM program structure, reporting requirements, and quality metrics
Experience interpreting and implementing ECM policy guidance and requirements from the Department of Health Care Services
Excellent analytical skills to evaluate program effectiveness and implement improvements
Advanced proficiency in healthcare data analysis and quality improvement methodologies
Exceptional leadership abilities with demonstrated success in team development
Strong communication and interpersonal skills
Ability to manage multiple priorities in a fast-paced environment
Commitment to person-centered care and health equity

Responsibilities

Team Leadership & Supervision Directly supervise and mentor Lead Care Managers across multiple counties in Northern California
Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals
Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion
Conduct regular performance evaluations and provide constructive feedback to optimize team performance
Program Development & Quality Assurance Establish comprehensive benchmarks and performance metrics for the ECM program
Design and implement quality assurance protocols to monitor service delivery and member outcomes
Develop standardized workflows and procedures to ensure consistency across counties
Member Services Oversight Ensure Lead Care Managers conduct regular in-person visits with ECM members
Monitor frequency and quality of member interactions through documentation reviews and ride-alongs
Implement strategies to improve member engagement and satisfaction
Cross-Functional Collaboration Serve as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizations
Collaborate with data analytics team to track program outcomes and identify improvement opportunities
Partner with compliance department to ensure adherence to regulatory requirements
Budget & Resource Management Develop and manage program budget, including staffing, operational costs, and member support resources
Allocate resources efficiently across counties based on member needs and program priorities
Track and report on program expenditures and return on investment
Program Innovation & Growth Identify opportunities to enhance program effectiveness through innovative approaches
Develop proposals for program expansion or new service offerings
Stay current on industry best practices and integrate relevant approaches

Benefits

160 Hours of Paid Time Off (PTO)
12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment
4 Paid Volunteer Hours per Month to support causes you care about
Bereavement Leave, including Fur Baby Bereavement
90% Employer-paid Employee-Only Medical Benefits
Dental and Vision Insurance
FSA | Dependent Care Account
401(k) with Company Match
Monthly Stipend
Short-Term & Long-Term Disability | AD&D
Employee Assistance Program (EAP)
Employee Discounts via Great Work Perks and Perks at Work
Quarterly In-Person Events
Opportunities for professional development and internal growth