Enhanced Care Management Lead

Neighborhood Healthcare•Escondido, CA

1d•Onsite

About The Position

The Enhanced Care Management (ECM) Lead will assist in program development and implementation of the care management operations for the ECM Program and patients. This role will support and oversee the daily operational and administrative activities of the care management teams. The primary role will involve training and mentoring staff, responding to daily questions, and ensuring the smooth operation of ECM activities to meet production goals. The Lead will collaborate with leadership, providers, and managed care teams to identify the needs of high-utilizer and vulnerable patient populations, developing care and service plans with linkages to various services. They will also work with community-based organizations to provide team-based, patient-centered care management and support the ECM Supervisor with daily operations, including staffing schedules and liaising with community partners. Building positive staff relationships, facilitating meetings and trainings, recommending personnel decisions, assessing training needs, and overseeing case file audits are also key aspects of this role. The Lead will conduct outreach, enrollment, reporting, and comprehensive assessments, provide direct care management services, respond to patient inquiries, and assist members in navigating the healthcare system. Collaboration within the ECM team and with the member's PCP is essential for improving care and outcomes, ensuring documentation is accurate and compliant with regulatory requirements.

Requirements

High school/GED required
Two years community outreach or behavioral health experience working with high-risk populations required
Valid CA driver’s license and proof of auto insurance required
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Knowledgeable about and experience with various characteristics of homeless adult populations, seniors, or other vulnerable populations
Knowledgeable about and experience with experience with issues of mental illness and/or chemical dependency
Knowledgeable about and experience with computer programs, such as Microsoft applications and electronic medical records
Ability to be sensitive and understand the emotions of others
Ability to demonstrate management of their own emotions and impulses
Ability to train and develop staff
Ability to successfully manage multiple tasks simultaneously
Ability to work with people of all social and ethnic backgrounds
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner
Ability to lift/carry 25 lbs/weight
Ability to stand for long periods of time

Nice To Haves

Experience working with the patient centered medical home preferred
Experience working within behavioral health, integrated primary care, or federally qualified health center (FQHC) settings preferred
Bilingual (English/Spanish) preferred
Lead experience preferred
completion of LEAP preferred (internal)

Responsibilities

Training and mentoring of staff and responding to daily questions.
Works with management to ensure the ECM operations is running smoothly and production goals are met.
Works with leadership, providers, and managed care teams to determine the needs of a high-utilizer and vulnerable patient populations, such as basic housing assistance and patient tailored intensive case management.
Develops care and service plans with linkages to medical, psychiatric, social, educational, and other services, as needed.
Works with community-based organizations to provide team-based and patient-centered care management for ECM patients.
Provides support to the ECM Supervisor by assisting with daily operations, such as managing staffing schedules, calendaring, and liaising with community partners.
Builds positive staff relationships, inspires others to perform at a higher level, and retains an accountable workforce.
Facilitates meetings and trainings with ECM teams to provide updates and develop strategies for program quality assurance, quality improvement, and compliance by following Neighborhood/program policies and procedures.
Recommends decisions to hire, transfer, reward, discipline or terminate employees.
Assesses training needs and promote developmental activities.
Oversees, reviews, and audits case files; provides prompt/actionable feedback to ECM team members.
Conducts outreach, enrollment, monthly reporting, and accurate completion of comprehensive risk assessments and care plans.
Conducts proper intake steps such as patient data collection, eligibility, program enrollment, care plan development, and assessment of needs.
Provides direct care management services to ECM participants in their assigned caseload in line with ECM guidelines and recommended services.
Responds to patient inquiries and refers patients to other departments, social services, or support services, as needed.
Assists members in navigating the healthcare system by finding and following up by phone and in-person with eligible ECM members.
Helps members participate in their medical and/or behavioral healthcare by overcoming barriers to care.
Documents and shares member barriers with ECM team and PCP to improve care and outcomes.
Works collaboratively within the ECM team to discuss responsibilities, task sharing, conflict resolution, and member case reviews.
Collaborates on member care issues with other ECM team members.
Participates in weekly case reviews and consults with the member's PCP before taking any clinical action.
Ensures documentation is accurate, helpful, and compliant with regulatory requirements and accreditation standards.
Participates in required staff meetings or other activities.
Contributes to the success of the organization by participating in quality improvement activities.
Documents in eClinicalWorks (eCW) for all care coordination, including services or teachings provided.
Prioritizes activities according to intensity, need, and required follow-up.
Provides accurate and timely reports to supervisor and manager, as required.