Supervisor, Care Management - ECM

HealthRIGHT 360•Santa Ana, CA

About The Position

HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic barriers to healthcare and promote health equity for all. We offer a wide range of services, including mental health care, residential and outpatient substance use treatment, and primary health services. Additionally, we provide transitional support for individuals re-entering the community after involvement in the criminal justice system. By integrating physical and behavioral health, we empower individuals to overcome challenges by addressing social determinants of health, fostering resilience, and facilitating recovery. CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and payment reforms across the Medi-Cal program. A key feature of CalAIM is the statewide introduction of an Enhanced Care Management (ECM) benefit and a menu of Community Supports, which, at the option of a Managed Care Plan (MCP), publicly funded health insurance plans for low-income citizens, can address the clinical and non-clinical needs of Populations of Focus with the most complex medical and social needs. Supervisor, Care Management will be responsible for implementing the ECM program to serve members under the Managed Care Plan (MCP) by providing care by linking clients with appropriate services to address specific needs such as physical and mental health, substance use disorder, (residential and outpatient) employment, Justice-Involved concerns, housing, community resources, and aftercare. The Supervisor, Care Management is required to identify and engage with each member in the community, including the member’s home, service provider locations and other, various locations requiring outreach. The Supervisor, Care Management will also hire, supervise, and train new staff incrementally, as the program grows to serve the expanding population.

Requirements

Bachelor’s degree in social work, Psychology, Nursing, Public Health, or a related field with At least 1 year of supervisory or leadership experience in healthcare, social services, or community-based setting.
OR
High School Diploma/GED with 3 years of supervisory or leadership experience in healthcare, social services, or community-based setting.
At least 3 years of case management experience working with high-need populations (Medi-Cal, Medi-Care and private Medical Insurance Plans).
Valid driver’s license, reliable transportation, and current auto insurance.
Knowledge of issues related to substance abuse, mental health, and criminal background.
Culturally competent and able to work with a diverse population.
Strong proficiency with Microsoft Office applications, specifically Word, Outlook, and internet applications.
Knowledge of care coordination across medical, mental health, and social service systems.
Strong communication and documentation skills.
The ability to work independently in a field-based environment and meet clients in varied community settings.
Proficiency with Microsoft Office, electronic health records (EHRs), and/or case management software.
Ability to complete documentation within required timeframes (e.g., 24-hour note completion standard).

Nice To Haves

AOD Certification from an accredited certifying body (CCAPP, CAADE, CADTP).
Two years’ experience in the human service field and/or demonstrated expertise in substance abuse treatment, relapse prevention, and recovery.
Experience working with clients experiencing acute withdrawal from substances.
Experience with providing trauma-informed services.
Experience delivering evidence-based practices preferred.
Master’s degree in social work (MSW), Counseling, Nursing, or a related behavioral health field.

Responsibilities

Program Implementation & Development
Organize, stabilize, and integrate the new project by meeting with representatives from the funding source (e.g. Molina, Blue Shield Promise, LA Care and other local MCPs).
Understand the needs of the population, referral and authorization processes, data-entry, and billing, to build a solid foundation for the program.
Create a framework that allows for community-based program expansion.
Organize patient care activities as outlined by the MCP and implement identified care coordination strategies.
Client Identification & Engagement
Identify eligible individuals for MCP enrollment from State Prisons, County Jails, hospitals, and other locations.
Use a variety of outreach and engagement strategies, including:
In-person meetings at the client’s location
Mail, email, texts, and phone calls
Street and community-level outreach
Collaborate with client advocates as appropriate.
Care Coordination & Case Management
Maintain regular communication with all providers involved in the members’ care team, including those related to Justice-Involved oversight.
Ensure care is continuous and well-coordinated across:
Primary care
Physical and developmental health
Mental health
SUD treatment
Housing and social services
Support client engagement through:
Medication coordination and reconciliation
Scheduling and reminders
Transportation coordination and accompaniment
Removing other barriers to care
Assessment & Client Support
Participate in intake by completing assessments required by the MCP.
Monitor clients' progress toward treatment plan goals and provide input.
Complete Releases of Information (ROIs) and assess clients’ care needs.
Connect clients to services and resources, including:
Medical and behavioral healthcare
Employment and education opportunities
Housing
Community and government resources (e.g., DPSS, DMV)
Team Collaboration
Engage with a multidisciplinary team to identify care gaps and obtain appropriate input.
Collaborate with clients and families to support community reintegration.
Coordinate with external agencies to support client access to needed resources.
Clinical Documentation
Write and complete all progress notes within 24 hours of service delivery.
Write clients’ progress letters and court reports.
Oversee clinical documentation for Lead Care Management staff as team expands, within a timely matter.
Training, Supervision and Quality Improvement Responsibilities
Facilitates Clinical Individual and Group Supervision as team expands.
Actively participates in agency and team meetings.
Participates in training opportunities.
Communicates collaboratively with all members of the behavioral health team including medical, mental health, psychiatry, substance use disorder, and other staff.
Completes all assigned training and Relias trainings in a timely manner.
And, other duties as assigned.