PHM Case Manager, Supervisor - Bakersfield 1.1
About The Position
The Case Management Supervisor plays a vital leadership role in overseeing the daily operations of the Kern County team, ensuring high-quality, person-centered services are provided to eligible members with complex health and social needs. The Case Management Supervisor will provide leadership and oversight of the Population Health Management (PHM) program, ensuring alignment with contractual obligations, compliance requirements, and organizational goals. The Supervisor will also serve individuals with chronic health conditions who are homeless or at-risk, have high hospital utilization, substance use disorders, behavioral health needs, and/or require assistance with social or community resources. Under the direction of the Manager of Case Management, the Case Management Supervisor is responsible for program implementation, staff supervision, performance management, and ongoing quality improvement efforts. This role is critical to ensure PHM services are delivered effectively, efficiently, and with high-quality care that meets the needs of complex members served through managed care health plans.
Requirements
- Bachelor’s degree in Nursing, Social Work, Public Health, or a related field required; OR active LVN license with 2 years of relevant experience in care coordination, case management, or a related setting.
- Strong knowledge of care management practices, social determinants of health, and trauma-informed care.
- Ability to lead and mentor staff in a fast-paced, member-centered environment.
- Excellent organizational, interpersonal, and communication skills.
- Proficient in using electronic health records, case management platforms, and Microsoft Office tools.
- Ability to analyze data and make informed decisions to improve outcomes and performance.
Nice To Haves
- At least 1 year of supervisory or lead experience in a healthcare or social services setting preferred.
- Experience working with Medi-Cal, CalAIM, or/and PHM/ECM programs strongly preferred.
- Knowledge of DHCS, NCQA guidelines, CMS, managed care, and PHM-related regulatory requirements is a plus.
- Bilingual in English and Spanish (or other prevalent language in service area) is a plus.
Responsibilities
- Oversee daily operations of the Population Health Management (PHM) program, ensuring alignment with state regulations, health plan requirements, and organizational standards.
- Monitor program compliance with managed care contracts and deliverables, conducting regular audits and tracking key performance indicators to ensure quality, accuracy, and adherence to PHM protocols.
- Evaluate program outcomes and performance metrics to identify areas for improvement and support the implementation of process enhancements and quality improvement initiatives.
- Provide direct supervision, coaching, and performance oversight to PHM staff, including Medical Social Workers, Care Coordinators, and related personnel.
- Manage caseload distribution and staffing capacity to ensure balanced workloads and appropriate member-to-staff ratios.
- Approve and manage employee schedules, timecards, and leave requests, ensuring adequate coverage and consistent productivity.
- Support staff development through onboarding, training, continuous education, and performance feedback; participate in hiring, evaluations, and corrective actions in collaboration with HR and program leadership.
- Foster a positive, accountable, and trauma-informed team culture aligned with organizational values.
- Monitor staff productivity, attendance, and documentation quality to ensure timely and appropriate member engagement, assessments, care planning, and service coordination.
- Conduct regular reviews and audits of clinical documentation and program activities to ensure compliance with PHM protocols and quality standards.
- Respond to member inquiries and refer members to appropriate departments, social services, or support resources as needed.
- Collaborate with Quality and Compliance departments to support audits, reporting requirements, and implementation of corrective action plans.
- Partner with PHM and Case Management leadership and cross-functional departments such as Behavioral Health, Social Services, IT, and Finance to promote integrated, interdisciplinary care coordination.
- Maintain effective communication with health plans, community-based organizations (CBOs), and internal stakeholders to support seamless care transitions and member-centered service delivery.
- Represent the PHM program at internal and external meetings, including health plan collaborations and community partnerships.
- Interpret and communicate program requirements and policies to staff, members, and community partners.
- Escalate complex cases or systemic barriers to appropriate internal or external resources while guiding staff through problem-solving strategies.
- Participate in the recruitment, onboarding, and evaluation of staff.
- Perform other duties and special projects as assigned.
Benefits
- Medical
- Dental
- Vision
- Paid Time Off (PTO)
- Floating Holiday
- Simple IRA Plan with a 3% Employer Contribution
- Employer Paid Life Insurance
- Employee Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
1-10 employees
