Enhanced Care Management Lead

Neighborhood Healthcare; Escondido (CA); On-site; USD 37,000 - 52,000; Full time

Job summary

Neighborhood Healthcare in Escondido, CA seeks an ECM Lead to assist in program development and oversee daily care management operations for the ECM Program and patients. This role will support and oversee the daily operational and administrative activities of the care management teams.

The ECM Lead will train staff, coordinate with leadership and care teams to identify needs of high-utilizer patients, develop integrated care plans, and ensure quality, compliance, and timely reporting.

Qualifications

• High school/GED required.
• Two years community outreach or behavioral health experience with high-risk populations required.
• Patient centered medical home experience preferred.
• Experience in behavioral health, integrated primary care, or FQHC settings preferred.
• Bilingual English/Spanish preferred.
• Lead experience preferred; LEAP preferred (internal).
• Valid CA driver’s license and proof of auto insurance required.

Responsibilities

• Train and mentor ECM staff; respond to daily questions.
• Work with management to ensure ECM operations run smoothly and meet production goals.
• Collaborate with leadership, providers, and managed care teams to identify needs of high-utilizer patients.
• Develop care and service plans linking medical, psychiatric, social, and educational services.
• Coordinate with community-based organizations to provide team-based, patient-centered care.
• Support ECM Supervisor with staffing, calendaring, and partner liaison.
• Foster positive staff relationships and promote accountable workforce.
• Facilitate meetings/trainings for QA, quality improvement, and compliance per policies.

Skills

Staff training

Mentoring

Leadership

Quality improvement

Education

High school/GED

Outreach/behavioral health

Patient-centered medical home

Integrated care / FQHC

Bilingual English/Spanish

Lead experience / LEAP

CA driver’s license

Tools

eClinicalWorks

Job description

ROLE OVERVIEW And PURPOSE

The Enhanced Care Management (ECM) Lead will assist in program development and implementation of the care management operations for the ECM Program and patients. This role will support and oversee the daily operational and administrative activities of the care management teams.

ROLE OVERVIEW And PURPOSE

The Enhanced Care Management (ECM) Lead will assist in program development and implementation of the care management operations for the ECM Program and patients. This role will support and oversee the daily operational and administrative activities of the care management teams.

Responsibilities

• Primary role will be training and mentoring of staff and responding to daily questions.
• Works with management to ensure the ECM operations is running smoothly and production goals are met
• Works with leadership, providers, and managed care teams to determine the needs of a high-utilizer and vulnerable patient populations, such as basic housing assistance and patient tailored intensive case management
• Develops care and service plans with linkages to medical, psychiatric, social, educational, and other services, as needed
• Works with community-based organizations to provide team-based and patient-centered care management for ECM patients
• Provides support to the ECM Supervisor by assisting with daily operations, such as managing staffing schedules, calendaring, and liaising with community partners
• Builds positive staff relationships, inspires others to perform at a higher level, and retains an accountable workforce
• Facilitates meetings and trainings with ECM teams to provide updates and develop strategies for program quality assurance, quality improvement, and compliance by following Neighborhood/program policies and procedures
• Recommends decisions to hire, transfer, reward, discipline or terminate employees
• Assess training needs and promote developmental activities
• Oversees, reviews, and audits case files; provides prompt/actionable feedback to ECM team members
• Conducts outreach, enrollment, monthly reporting, and accurate completion of comprehensive risk assessments and care plans
• Conducts proper intake steps such as patient data collection, eligibility, program enrollment, care plan development, and assessment of needs
• Provides direct care management services to ECM participants in their assigned caseload in line with ECM guidelines and recommended services
• Responds to patient inquiries and refers patients to other departments, social services, or support services, as needed
• Assists members in navigating the healthcare system by finding and following up by phone and in-person with eligible ECM members
• Helps members participate in their medical and/or behavioral healthcare by overcoming barriers to care
• Documents and shares member barriers with ECM team and PCP to improve care and outcomes
• Works collaboratively within the ECM team to discuss responsibilities, task sharing, conflict resolution, and member case reviews
• Collaborates on member care issues with other ECM team members
• Participates in weekly case reviews and consults with the member's PCP before taking any clinical action
• Ensures documentation is accurate, helpful, and compliant with regulatory requirements and accreditation standards
• Participates in required staff meetings or other activities

Quality Management & Record Keeping:

• Contributes to the success of the organization by participating in quality improvement activities
• Documents in eClinicalWorks (eCW) for all care coordination, including services or teachings provided
• Prioritizes activities according to intensity, need, and required follow-up
• Provides accurate and timely reports to supervisor and manager, as required

Education/Experience

• High school/GED required
• Two years community outreach or behavioral health experience working with high-risk populations required
• Experience working with the patient centered medical home preferred
• Experience working within behavioral health, integrated primary care, or federally qualified health center (FQHC) settings preferred
• Bilingual (English/Spanish) preferred
• Lead experience preferred; completion of LEAP preferred (internal)
• Valid CA driver’s license and proof of auto insurance required

ADDITIONAL QUALIFICATIONS (Knowledge, Skills And Abilities)

• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Knowledgeable about and experience with various characteristics of homeless adult populations, seniors, or other vulnerable populations
• Knowledgeable about and experience with experience with issues of mental illness and/or chemical dependency
• Knowledgeable about and experience with computer programs, such as Microsoft applications and electronic medical records
• Ability to be sensitive and understand the emotions of others
• Ability to demonstrate management of their own emotions and impulses
• Ability to train and develop staff
• Ability to successfully manage multiple tasks simultaneously
• Ability to work with people of all social and ethnic backgrounds
• Excellent planning and organizational ability
• Ability to work as part of a team as well as independently
• Ability to work with highly confidential information in a professional and ethical manner

Physical Requirements

• Ability to lift/carry 25 lbs/weight
• Ability to stand for long periods of time

Pay Range

$27.2100 to $38.0900 per hour, depending on experience

Compensation Disclosure:

The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.