Description:

• Provide Enhanced Care Management (ECM) services to members with complex medical, behavioral health, and/or social needs.
• Manage an assigned caseload while maintaining consistent member engagement, outreach, and follow-up.
• Conduct comprehensive assessments and identify medical, behavioral health, and social service needs.
• Develop, maintain, and update individualized care plans based on member needs and established goals.
• Hands-on experience completing and documenting POFs, including gathering required member information and ensuring accurate and timely completion, is strongly preferred.
• Complete required screenings, assessments, specialty summaries, case notes, and other ECM documentation within established timelines.
• Coordinate care across primary care, specialty care, behavioral health, community organizations, and other service providers.
• Track referrals, appointments, care gaps, member progress, and follow-up activities.
• Assist members in navigating healthcare systems and accessing appropriate services and community resources.
• Identify and address social determinants of health, including housing, food insecurity, transportation, benefits, and other barriers to care.
• Maintain accurate, timely, and compliant documentation within the electronic health record (EHR/EMR).
• Experience working with Medi-Cal, managed care, community health, ECM, or complex/vulnerable populations is strongly preferred.
• EPIC experience is highly preferred.
• Knowledge of medical terminology is preferred.
• Strong communication, organization, documentation, time management, and member engagement skills are required.

Candidate Screening

• Please do not submit candidates based solely on general case management experience.
• Priority will be given to candidates with hands-on ECM experience, particularly experience with POFs, individualized care plans, screenings/assessments, member outreach, care coordination, and timely documentation.
• When submitting candidates, please include:
• Pay expectation | Availability/start date | ECM experience | POF experience | Care plan experience | EHR/EPIC experience
• We are looking to fill this position quickly and will prioritize qualified candidates who are available to interview promptly.