ECM Supervisor

Elica Health Centers • North Highlands, CA

6d • Onsite

About The Position

Join Elica’s mission and become a part of a team where every day is an opportunity to make a positive impact in your community! At Elica Health Centers, we share a common goal: provide the best possible patient care to our growing community! Our passion extends throughout Elica, from the exceptional healthcare services we provide to our underserved patients at our Community Health Clinics and state-of-the-art mobile medicine program, Health on Wheels, to our Resource Center where we empower patients and members of the community to connect with resources to help them build healthy and full lives. We are growing our Enhanced Care Management (ECM) program at Elica! ECM is a key part of CalAIM’s statewide Medi-Cal benefit available to select “Populations of Focus" with complex needs and who are facing difficult life and health circumstances. This program is focused on breaking down the traditional walls of health care – extending beyond hospitals and health care settings into communities. ECM addresses clinical and non-clinical needs of the highest-need enrollees through intensive coordination of health and health-related services and will meet beneficiaries wherever they are – on the street, in a shelter, in their doctor's office, or at home.

Requirements

• Minimum of a Bachelor's degree
• A minimum of three years of Care Management
• Prior experience in a supervisory or team lead role is required.
• Knowledge of the ECM Program and documentation requirements.
• Proficiency with EPIC and Client Centered Care Planning.
• Computer and technology skills.
• Excellent computer skills in a Microsoft Windows environment.
• Must include knowledge of Excel and skills in Google Workspace.
• Knowledge and experience in social services and community resources.
• Knowledge of the functions, operation, and mission of the specific department.
• Better than average written and spoken communication skills.
• Outstanding interpersonal relationship building and business communication skills.
• General knowledge of various MHPs and state programs.
• Evidence of the ability to practice a high level of confidentiality.
• Excellent organizational and time management skills.
• Must have a current and valid California driver’s license and the ability to provide proof of personal auto insurance on the vehicle driven during working hours.

Nice To Haves

• Experience in outreach and inter-agency referral services preferred
• 3 years of experience with Assessment and Care Planning (SMART format) is strongly preferred
• 3 years of experience with SOAP/encounter note writing is strongly preferred
• 3 years of experience managing 50 or more cases is preferred
• Experience working with the Individuals Experiencing Homelessness, Chronically ill, Substance Use Disorders, and Serious Mental Illness
• Knowledge of medical terminology
• Strong understanding of HIPAA
• Experience in a team-oriented workplace is preferred.
• Demonstrated ability to serve as a knowledgeable resource to the organization's management team that provides leadership and direction.
• Participates in cross trainings of ECM Care Managers and CHWs.
• Participates in quarterly and annual health plan audits including credentialing and medical records.
• Participates in and leads peer quality assurance processes.
• Participates in recruiting and onboarding new hires.
• Seeks new opportunities for community partnerships, including, but not limited to service providers that maybe a resource to clients and referring partners.
• Attends regular meetings with management, MCPs, CalAIM collaboratives and the team.
• Monitors and approves staff time and attendance, including time cards, PTO requests, and sick leave, to ensure adequate program coverage and compliance with organizational policies and payroll requirements.
• Maintain consistent attendance and punctuality.
• Other duties as assigned.
• Internal applicant: transition the client panel to other program staff over the period of 2 weeks with client records meeting all of the program requirements.

Responsibilities

• Under the guidance of the CalAIM Manager, the Enhanced Care Management (ECM) Supervisor's overall role is to communicate organizational needs, oversee employees' compliance with the CalAim ECM and Managed Care Plans (MCPs) requirements, provide guidance on compliance with the CalAim ECM and MCP requirements, support compliance with the CalAim ECM and MCP requirements, identify development needs, onboard and train new team members and supervise the ECM team’s day to day operations ensuring the successful completion of program requirements.
• The ECM Supervisor focuses on supervising and daily operations and staff’s compliance in providing care coordination/case management services to clients enrolled in the ECM program.
• The ultimate goal of all services provided is assisting the client with obtaining medical and behavioral health support with medical and community resources referrals, income, medical insurance, social service supports, and housing referrals.
• All goals are managed by development and implementation of a client centered care plan.
• The ECM Supervisor, in collaboration with the ECM Clinical Consultant, is responsible for overseeing the development and implementation of the patient centered care plan by the ECM Care Managers.
• The ECM team is a part of the Social Care Department and works in close collaboration with the Community Supports team, other support programs, Elica’s departments and services, and community partners.
• Supports the team with guidance on Managed Health Plans’ requirements for the successful operation of the ECM program on day-to-day basis.
• Supports the team with overseeing and coordinating changes in the ECM program requirements as directed by leadership, CalAIM Management and Operations, DHCS and MHPs.
• Works closely with EHR and ECM Care Manager Lead(s) to coordinate training for new ECM Care Managers and ongoing training for existing staff.
• Interprets and explains program requirements, workflows and policies to staff and new hires to support the success of the program.
• Supervises, supports, and evaluates the performance of ECM Care Managers, providing guidance, training, and mentorship to ensure optimal client outcomes and service delivery.
• Identifies gaps and non-compliances and report them in a timely/immediately manner.
• Ensures compliance with Health Plans requirements by reviewing and approving documentation.
• Monitors quality of Assessments and implementation of Care Plans.
• Recommends revisions or updates as necessary to accomplish the ECM Member’s goals.
• Ensures that the ECM Care Managers provide services in line with the program expectations as demonstrated by documentation produced by the staff.
• Ensures that staff maintains follow through with service delivery and closing the loop on referrals, patient education and interventions.
• Works closely with CalAIM Quality Assurance Specialist and Lead Community Health Worker Under the directions of the CalAIM Manager, monitors and addresses Quality Oversight reports in order to monitor the operation of the program and staff progress.
• Supervises staff panels to ensure that the department meets monthly, quarterly, and annual enrollment targets, as well as client contact targets.
• Coordinates Crisis or Complaint intervention and advocates for clients, as needed.
• Responsible for emergency case activity in the absence of the care manager for any reason and for submission of needed data.
• ECM Supervisor works with the leadership and CalAim Financial team ensuring that workflows meet MHPs billing requirements.
• Receives feedback from Management, CalAIM Quality Assurance Specialist, MCPs and addresses workflow adherence with staff.
• As required by internal and external agencies, performs regular internal audits to evaluate team compliance with program requirements; documents findings, provides coaching and corrective guidance, and monitors follow-up actions to maintain program integrity.
• Coordinates with the Lead Community Health Worker (CHW) or the CHW team in the absence of the Lead.
• Participates in cross trainings of ECM Care Managers and CHWs.
• Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment, including, but not limited to monthly success stories.
• Arranges and leads weekly meetings with care managers to assess caseload activity and address questions related to company and program policies and procedures, workflow, and community resources.
• Arranges and facilitates bi-weekly meetings between the ECM team and the ECM Clinical Consultant and bi-weekly case consultation meetings with the ECM Clinical Consultant and the behavioral health consultants.
• Participates in quarterly and annual health plan audits including credentialing and medical records.
• Participates in and leads peer quality assurance processes.
• Participates in recruiting and onboarding new hires.
• Seeks new opportunities for community partnerships, including, but not limited to service providers that maybe a resource to clients and referring partners.
• Attends regular meetings with management, MCPs, CalAIM collaboratives and the team.
• Monitors and approves staff time and attendance, including time cards, PTO requests, and sick leave, to ensure adequate program coverage and compliance with organizational policies and payroll requirements.
• Maintain consistent attendance and punctuality.
• Other duties as assigned.
• Internal applicant: transition the client panel to other program staff over the period of 2 weeks with client records meeting all of the program requirements.

Benefits

• Medical, Dental & Vision Insurance – Choice of PPO medical plans through Anthem Blue Cross, including a Premier PPO option with $0 in-network out-of-pocket costs, plus dental and vision coverage.
• Health Plans include care navigation and provider support resources to help with finding care, understanding benefits, and billing questions.
• Coverage options are available for individual and family tiers.
• Up to 3 weeks of vacation in the first year, plus 7 paid holidays and 1 floating holiday
• 403(b) plan with up to 4% employer match and immediate vesting
• Employer-paid life insurance, Employee Assistance Program (EAP), Flexible Spending Accounts (Health Care & Dependent Care), and optional supplemental benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Manager