Enhanced Care Management Lead Care Manager - Santa Cruz County

Pacific Health Group

4h•Hybrid

About The Position

At Pacific Health Group, we’re more than just a healthcare organization—we’re a catalyst for positive change in our communities. Our Enhanced Care Management (ECM) programs focus on addressing social determinants of health and providing community-based services that truly meet each individual’s needs. As a 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. This role is crucial because it goes beyond coordinating clinical visits to respond to real-life challenges such as housing, food insecurity, and mental health, ensuring comprehensive member needs are addressed. By forming strong, personal connections through frequent in-person visits, you’ll become a pivotal support system—someone members can rely on for comfort, guidance, and advocacy.

Requirements

Must reside in listed County
3–5 years in case management, social services, or healthcare
Excellent communication, organization, and time management skills
Proficiency with documentation systems and technology
Ability to effectively communicate both written and verbally
Valid California Driver’s License and active auto insurance meeting CA requirements
Reliable personal vehicle for daily work use
Successful completion of background check (including MVR)
Must be able to travel up to 60-70% within the county to conduct in person visits
Must successfully complete a Testlify skills assessment
Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received
Must have effective Time Management skills
Must have internet speed of - 300+ mbps download and 25+mbps upload
Must be proficient in technology, including documentation systems, case management platforms, and communication tools

Nice To Haves

Experience with: Medi-Cal, CalAIM, or Enhanced Care Management (preferred)
Working experience of healthcare systems and community resources is a plus

Responsibilities

Manage a caseload of approximately 60–70 members
Conduct 3–5 in-person visits per day (homes, shelters, community settings)
Spend 60–70% of your time in the field
Travel locally within Santa Clara County (mileage reimbursed)
Coordinate care across medical, behavioral health, and community services
Document in real-time or by end of day using internal systems
Develop and manage individualized care plans
Coordinate appointments, services, and follow-ups across providers
Support transitions of care (hospital discharge, referrals, etc.)
Build trust through consistent, in-person engagement
Advocate for timely access to care, services, and resources
Support members navigating housing, food access, transportation, and behavioral health needs
Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives
Build and maintain relationships with community-based organizations, shelters, and local resource partners
Identify opportunities to expand community presence and improve member access to services
Connect members to local programs and services
Build relationships with community-based organizations
Identify gaps in resources and escalate when needed
Complete timely and accurate documentation
Maintain compliance with Medi-Cal, CalAIM, and ECM program requirements
Partner with internal teams, providers, and community stakeholders
Participate in case conferences and care coordination meetings