About the position
The official job title is Lead Care Manager (LCM). The Lead Care Manager (LCM) role involves developing personalized care plans, coordinating member services, and collaborating closely with members and families, as well as Primary Care Providers to ensure they receive necessary medical treatment and support. The LCM will consult with members to determine their needs, develop individualized action plans, and work with care teams to manage the member experience effectively. Providing emotional support, resolving administrative issues, and ensuring timely access to care are key aspects of the position. Compassion, healthcare knowledge, and exceptional customer service are essential qualities for assisting members in becoming self-sufficient in health. The LCM will work with a diverse population of members enrolled in the Enhanced Care Management program, which may involve one or multiple members from the population of focus section below.
Responsibilities
- Interview members to assess medical and social determinant of healthcare gaps and provide education about their condition and medication, while developing individualized care plans.
- Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.
- Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
- Maintain on-going contact with members, via telehealth and in-person visitation.
- Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.
- Maintain empathy and professionalism while contacting members and families.
- Supporting behavioral health coordination, Substance Abuse and Community Resources.
- Perform additional duties as assigned.
Requirements
- High school diploma or GED required.
- Minimum of 1 year experience in case management, member care, customer service, call center, or member care required.
- Valid California driver's license and valid vehicle insurance required.
Nice-to-haves
- MA certificate or medical terminology knowledge preferred.
Benefits
- Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.
- Short & Long-Term Disability Benefits: Protection when you need it most.
- Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.
- Flexible Spending Accounts: Manage your finances with flexibility.
- Employee Assistance Program (EAP): Support when life throws challenges your way.
- 401(K): Building your financial future with us. Effective after 1 year of employment.
- Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.
- Paid Holidays: Quality time to enjoy celebrations.
- Employee Referral Program: Share the opportunities and reap the rewards.
- Company Discount Program: Enjoy savings on everyday expenses and memberships.
