Lead Care Manager – ECM/CHI & Health Equity

GroundGame.Health; Fresno (CA); On-site; USD 70,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Life and disability insurance

Job summary

GroundGame.Health is seeking a Lead Care Manager in Fresno, CA to identify, enroll, and support members in CalAIM ECM, CHI, and CHW programs. You will integrate social care into clinical settings, ensure timely assessments, coordinate care, and connect members with healthcare and community resources.

You will lead a team of CHWs, provide coaching, monitor performance, and ensure compliant documentation across EHR and Implify platforms. Onsite presence is required in the Fresno area.

Qualifications

• CHW Certification required or 2+ years in care coordination.
• EMR systems experience required.
• Willingness to travel between locations and patients' homes.
• On-site work in provider clinics and patients' homes.
• Bilingual in English and Hmong.

Responsibilities

• Identify and engage members in CalAIM ECM, CHI, CHW and related programs.
• Provide care coordination, assessments, and referrals.
• Lead a team of CHWs, coach and review documentation.

Skills

EMR experience

Travel readiness

Driver's license

Bilingual English/Hmong

On-site work

Education

CHW Certification

Bachelor's degree preferred

Tools

Implify platform

Job description

GroundGame.Health is seeking a Lead Care Manager in Fresno, CA to identify, enroll, and support members in CalAIM ECM, CHI, and CHW programs. You will integrate social care into clinical settings, ensure timely assessments, coordinate care, and connect members with healthcare and community resources.

You will lead a team of CHWs, provide coaching, monitor performance, and ensure compliant documentation across EHR and Implify platforms. Onsite presence is required in the Fresno area.