Lead ECM Care Manager — Housing & Care Coordination

Central Neighborhood Christian Health Clinics; San Bernardino (CA); On-site; USD 90,000 - 115,000; Full time

Job summary

Central Neighborhood Health Foundation in San Bernardino is seeking an ECM Lead Care Manager to coordinate comprehensive care for high-need Medi-Cal members. You will work with leaders, providers, and managed care to develop and implement patient-centered care plans and linkages to medical, housing, and social services.

The role requires strong assessment, outreach, and documentation in the EMR, with a focus on preventing unnecessary hospital use and supporting housing stability, including

Qualifications

• High school diploma required.
• Bachelor’s degree preferred.
• Two years of experience in the health care, case management, or related field preferred.

Responsibilities

• Conducts initial screening, assessments, and reassessments to determine the continued needs of the client.
• Outreach, enrollment, monthly reporting, and completion of risk assessments and care plans.
• Intake steps including data collection, eligibility, enrollment, and care plan development.
• Develop and implement patient-focused care plans for clients with chronic conditions.
• Provide direct care management services within ECM guidelines.
• Maintain accurate records in EMR and documentation systems.
• Engage with Housing Navigation to support homeless or at-risk patients.
• Conduct home or site visits multiple days a week.
• Participate in interdisciplinary case conferences and monthly health plan webinars.

Skills

Reliable transportation

Driver's license

Ability to drive

Education

High school diploma

Bachelor's degree

Job description

Central Neighborhood Health Foundation in San Bernardino is seeking an ECM Lead Care Manager to coordinate comprehensive care for high-need Medi-Cal members. You will work with leaders, providers, and managed care to develop and implement patient-centered care plans and linkages to medical, housing, and social services.

The role requires strong assessment, outreach, and documentation in the EMR, with a focus on preventing unnecessary hospital use and supporting housing stability, including