Lead Care Manager
About The Position
The Lead Care Manager develops personalized care plans, coordinates member services, and collaborates with members, families, Primary Care Providers, and care teams to ensure members receive needed medical treatment and support. The role assesses member needs, develops individualized action plans, supports effective member experiences, provides emotional support, resolves administrative issues, and helps ensure timely access to care. The position serves a diverse population enrolled in the Enhanced Care Management program, including members in one or more of the listed populations of focus. The role includes ongoing member contact through telehealth and in-person visits, advocacy and coordination with healthcare providers, and support with behavioral health, substance use, and community resources. The position requires outreach travel using a personal vehicle, current TB testing and clearance, prolonged computer-based desk work, and the ability to lift up to 15 pounds.
Requirements
- High school diploma or GED.
- At least 1 year of experience in case management, member care, customer service, call center, or member care.
- Valid California driver's license and valid vehicle insurance.
- Excellent communication, interpersonal, customer service, and organizational skills.
- Computer skills for documentation, email, and chat support.
- Ability to work independently and collaboratively in a team to provide member care.
- Ability to multitask, stay organized, and maintain attention to detail while providing care to multiple members simultaneously.
- Ability to use resources effectively to solve problems and remain composed under pressure in a compassionate manner.
- Proficient speaking, reading, and typing abilities, with strong proofreading skills.
- Ability to travel in a personal vehicle for outreach visits.
- Ability to complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local and state health regulations.
- Ability to sit for prolonged periods at an office desk using a computer.
- Ability to lift up to 15 pounds.
Nice To Haves
- Medical assistant certificate or knowledge of medical terminology.
Responsibilities
- Interview members to assess medical and social determinant of health gaps, provide education about conditions and medications, and develop individualized care plans.
- Respond to member inquiries and concerns while ensuring adherence to hospital and legal requirements.
- Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
- Maintain ongoing contact with members through telehealth and in-person visits.
- Advocate for members; consult with healthcare providers; arrange appointments and treatment plans; evaluate member progress; and help address healthcare barriers.
- Communicate with members and families with empathy and professionalism.
- Support behavioral health coordination, substance abuse services, and community resources.
- Perform additional duties as assigned.
Benefits
- Medical, dental, and vision insurance options for employees and their families, available to full-time employees after 60 days of employment.
- Short- and long-term disability benefits.
- Voluntary accident, critical illness, and hospital indemnity plans.
- Flexible Spending Accounts.
- Employee Assistance Program.
- 401(k), effective after 1 year of employment.
- Paid vacation and sick leave.
- Paid holidays.
- Employee referral program.
- Company discount program.
- Mileage reimbursement for use of a personal vehicle at a standard rate.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
