Enhanced Care Management Lead Care Manager

A Better Way Inc•Oakland, CA

8h•Onsite

About The Position

Under the supervision of the ECM Supervisor, the Lead Care Manager is responsible for coordinating care and services for children, youth, and families enrolled in A Better Way's Enhanced Care Management (ECM) Program. The Lead Care Manager serves as the primary point of contact for members, families, healthcare providers, schools, child welfare agencies, behavioral health providers, and community partners. The Lead Care Manager utilizes a person-centered, family-driven, trauma-informed approach to engage families, identify strengths and barriers, coordinate services, ensure successful linkage to healthcare, behavioral health, educational, and community resources. The position requires extensive knowledge of community-based systems of care, Medi-Cal services, CalAIM initiatives, social determinants of health, and family engagement practices. The Lead Care Manager also supports program development efforts including referral management, resource development, community outreach, stakeholder engagement, and maintenance of community resource directories and service navigation tools.

Requirements

Bachelor's degree in Social Work, Human Services, Public Health, Psychology, Child Development, Sociology, or a related field, or an equivalent combination of education and at least three (3) years of experience working with children, youth, and families in community-based settings.
Demonstrated experience navigating healthcare, behavioral health, child welfare, educational, and social service systems.
Strong understanding of systems of care and community resource networks.
Experience coordinating services among multiple providers and stakeholders.
Excellent communication, engagement, and relationship-building skills.
Proficient in Microsoft Office Suite (Word, Excel, Outlook, and Teams) and electronic health record (EHR) systems.
Ability to accurately enter, maintain, and retrieve data in electronic databases and care management platforms.
Strong computer skills, including electronic documentation, virtual meeting platforms, internet research, and use of cloud-based applications.
Valid California Driver's License, reliable transportation, and proof of current automobile insurance meeting California minimum coverage requirements.
Ability to travel throughout assigned service areas.

Nice To Haves

Experience providing Enhanced Care Management (ECM), Targeted Case Management, Wraparound, or Care Coordination services.
Knowledge of CalAIM and Medi-Cal managed care systems.
Bilingual English/Spanish, or other threshold language.
Experience working with foster youth, child welfare, behavioral health, or complex care populations.

Responsibilities

Serve as the Lead Care Manager for assigned ECM members.
Conduct outreach, engagement, and relationship-building activities with children, youth, and families.
Complete comprehensive assessments and develop individualized care plans.
Coordinate services across medical, behavioral health, educational, social service, and child welfare systems.
Monitor progress toward care plan goals and update plans as required.
Ensure timely follow-up on referrals and care coordination activities.
Maintain closed-loop referrals to confirm families successfully access recommended services.
Establish and maintain relationships with Primary Care Providers (PCPs), specialists, hospitals, and healthcare organizations.
Facilitate communication between healthcare providers and families.
Coordinate appointments, follow-up care, medication support, and treatment recommendations.
Support families in navigating healthcare systems and understanding medical care plans.
Participate in multidisciplinary care meetings and case conferences.
Review and coordinate incoming ECM referrals.
Assist in determining member eligibility and appropriate service linkage.
Track referral outcomes and service engagement.
Identify barriers to care and develop strategies to address access challenges.
Maintain current knowledge of community resources throughout Alameda and San Francisco Counties.
Develop, maintain, and regularly update ECM resource guides and community resource binders.
Serve as a primary liaison between A Better Way and external partners.
Build collaborative relationships with Health Plans, Primary Care Providers, Behavioral Health Providers, Child Welfare Agencies, School Districts, Regional Centers, Community-Based Organizations, and Juvenile Justice Partners.
Represent A Better Way at community meetings, provider collaboratives, and stakeholder events.
Promote awareness of ECM services and strengthen referral pathways.
Utilize motivational interviewing and family-centered engagement strategies.
Support families in understanding and navigating complex service systems.
Collaborate with Parent Partners and Family Partners to increase family engagement and service success.
Assist families in identifying natural supports and community connections.
Promote self-advocacy and long-term family stability.
Assist the ECM Supervisor in developing workflows, referral processes, and service coordination practices.
Participate in program quality improvement activities.
Support development of training materials and resource tools.
Assist with tracking program outcomes and performance measures.
Contribute to program growth and sustainability efforts.
Complete documentation within required timelines.
Maintain accurate records within the electronic health record.
Participate in audits, chart reviews, supervision, and training activities.
Maintain compliance with Medi-Cal, CalAIM, HIPAA, and agency requirements.
Participate in all mandatory trainings, including those required at onboarding and throughout the year, to maintain compliance and support ongoing professional development.
Participate in regular competency and performance evaluations to support professional development, ensure role effectiveness, and maintain alignment with program and organizational standards.
Follow regulatory guidelines, mandated reporting, and program/agency protocols in performing duties.
Abide by all provisions of the A Better Way personnel manual.
Perform any other duties as directed.