ECM RN Care Manager

SYMBA CENTER•Victorville, CA

7d•$45 - $49•Hybrid

About The Position

The Registered Nurse Care Manager (RN CM) is a key member of the multidisciplinary, integrated Enhanced Care Management (ECM) Care Team, which also includes a Behavioral Health Care Manager (BH CM), Care Coordinator (CC), and Community Health Worker (CHW). The RN CM is primarily responsible for supporting ECM Members with complex medical conditions, focusing on high-risk caseloads, and leading various assessment efforts across the program.

Requirements

Bachelor's degree from an accredited school of nursing
Unrestricted California Registered Nurse license
Current BLS certification
Personal malpractice insurance
Valid California Driver's License with active auto insurance
Ability to pass a background check
Strong computer and EHR proficiency
High-level communication and interpersonal skills
Ability to work compassionately with underserved populations while exercising sound judgment and managing a variable workload
Demonstrates advanced knowledge of CalAIM Enhanced Care Management services, regulatory requirements, and operational practices necessary to effectively manage program performance and client outcomes.
Comprehensive knowledge of CalAIM Enhanced Care Management (ECM), including eligibility, care coordination requirements, and Managed Care Plan expectations.
Ability to interpret and implement DHCS regulations, Model of Care requirements, contractual obligations, and organizational policies.
Knowledge of population health strategies, care management principles, and interventions for individuals with complex medical, behavioral health, and social needs.
Ability to monitor program performance, enrollment, engagement, and quality metrics to improve outcomes and ensure contract compliance.
Understanding of HEDIS measures, care gap identification, and quality improvement methodologies.
Demonstrates the ability to lead multidisciplinary teams, foster collaboration, and drive program success through effective communication and decision-making.
Ability to supervise, mentor, and develop multidisciplinary care teams while promoting accountability and professional growth.
Strong leadership, problem-solving, and decision-making skills, with the ability to exercise independent judgment in managing program operations and staff performance.
Excellent communication and interpersonal skills, with the ability to build productive relationships with staff, healthcare providers, managed care plans, and community partners.
Ability to facilitate case reviews, team meetings, and collaborative discussions that support quality care and effective service delivery.
Demonstrated ability to lead multidisciplinary teams, interpret regulatory guidelines, and manage programmatic budgets/metrics.
Proficiency in Google Workspace, EHR systems, and care management platforms.
Demonstrates the ability to maintain program compliance, oversee documentation standards, and utilize data to support performance monitoring and continuous improvement.
Knowledge of regulatory compliance requirements, documentation standards, and reporting obligations related to ECM services.
Ability to oversee audits, monitor documentation quality, and ensure compliance with DHCS, Managed Care Plan, and organizational requirements.
Proficiency in electronic health records (EHR), care management platforms, reporting systems, and Google Workspace.
Ability to analyze program data, performance metrics, and clinical outcomes to identify trends, address deficiencies, and support quality improvement initiatives.
Understanding of billing processes, claims management, data integrity requirements, and financial accountability measures.
Demonstrated ability to work effectively with diverse populations while promoting dignity, equity, inclusion, and person-centered care.
Demonstrated cultural humility and ability to work effectively with individuals from diverse backgrounds and lived experiences.
Understanding of social determinants of health, health disparities, and barriers impacting access to healthcare and supportive services.
Ability to engage clients, staff, and community partners with empathy, professionalism, and a strengths-based, person-centered approach.
Commitment to ethical decision-making, confidentiality, and professional integrity in all interactions.
Promotes an inclusive, collaborative, and respectful work environment that supports continuous learning and quality service delivery.
Connects personal work outputs to organizational impact.
Prioritizes community benefit over convenience or ego.
Uses Symba’s values in tradeoff decisions (e.g., speed vs. quality vs. equity).
Uses inclusive language and practices; adapts communication styles.
Anticipates barriers for underserved stakeholders and designs equitable solutions.
Reflects on personal biases and invites feedback; elevates underrepresented voices.
Protects confidentiality.
Follows mandatory reporting and risk protocols without delay.
Flags conflicts of interest; chooses ethical paths even when inconvenient.
Tailors messages to audience (community, funders, coworkers).
Practices active listening; clarifies assumptions and decisions.
Escalates issues constructively; closes the loop on commitments.
Sets and meets expectations; follows through reliably.
Treats every stakeholder with dignity; handles complaints gracefully.
Balances responsiveness with boundaries and sustainability.
Meets deadlines; communicates risks early.
Follows standard operating procedures (SOPs); improves them over time.
Owns outcomes; corrects mistakes quickly.

Nice To Haves

Ability to work flexible hours, as required, including weekends and holidays.

Responsibilities

Support ECM Members with complex medical needs, primarily managing a caseload of Tier 1 and Tier 2 Members.
Complete and conduct medication reconciliations for all ECM-enrolled Members in collaboration with pharmacy services (where available) and input from the Member’s Primary Care Provider (PCP).
Ensure smooth transitions of care by coordinating regarding Member admissions and discharges (coordinating with hospitals for M1 or with the IEHP transitions of care team for M2).
Serve as the clinical reference for the ECM Care Team by consulting on clinical concerns, providing education on chronic disease states, prevention, treatment, medications, and healthy living.
Receive, identify, and promptly follow up on treatment and medication alerts.
Track and assure the completion of required assessments and screenings, including but not limited to Comprehensive Health Assessments (CHAs), DCME’s, and Shared Care Plans.
Review completed Comprehensive Health Assessments (a role shared with the Behavioral Health Care Manager).
Work directly with Members to identify health and wellness goals, incorporating them into Health Action Plans / Shared Care Plans to facilitate communication between Members and healthcare providers.
Engage Members to support and encourage their activation toward achieving individual health goals and championing healthy lifestyle changes.
Provide education to Members and their families regarding chronic medical and behavioral health conditions to improve health literacy.
Duties may include outreach efforts, as needed to support members.
Promote a collaborative, effective team environment by using evidence-based communication strategies (e.g., Motivational Interviewing), sharing tasks, resolving conflicts, and leading Member case discussions.
Gather input from other ECM Care Team members to prioritize Member cases for systematic population/caseload reviews.
Coordinate physical care management and build care coordination relationships with external healthcare providers.
Facilitate and ensure clinical recommendations are effectively communicated across the entire healthcare team.
Track medical and behavioral health outcome measures within the web-based care management platform (or equivalent platform).
Ensure documentation is complete and accurate in accordance with Symba Center policies.
All other duties as assigned