PACE Lead Care Manager

United Health Centers of the San Joaquin Valley; Fresno (CA); On-site; USD 30,000 - 43,000; Full time

Benefits offered by this job

Medical Insurance

Paid Time Off

401k Matching

Educational Assistance

Employee Discounts

Job summary

United Health Centers of the San Joaquin Valley is seeking a PACE Lead Care Manager to coordinate care plans and serve as the primary contact for participants, families, and the care team. The role emphasizes collaboration with the IDT, documentation, and proactive outreach to prevent disenrollment.

You will manage caseloads, participate in IDT meetings, and ensure timely service delivery, transportation scheduling, and referrals while maintaining HIPAA compliance and patient-centered care.

Qualifications

• LVN license or MA certification, or a Bachelor's degree, or 3+ years of relevant experience.
• High school diploma or GED required.
• Valid driver's license is required.
• 3+ years of progressive healthcare experience preferred.

Responsibilities

• Serve as primary contact for participants, families, AR, caregiver, and the interdisciplinary care team.
• Manage a full participant caseload and coordinate service delivery.
• Attend IDT meetings and document discussions; coordinate discharge planning.
• Coordinate with transportation and scheduling to support care delivery.
• Ensure care plans are implemented and track progress with providers.

Skills

Bilingual English/Spanish

Strong communication skills

Customer-service oriented

MS Office proficient

Medical management software knowledge

Education

High school Diploma or GED

Bachelor's degree preferred

Tools

MS Office

Medical management software

Job description

Overview

We are recruiting for a PACE Lead Care Manager to join our growing team.

Under the direction of the Center Director, the PACE Lead Care Manager is responsible for serving as the primary point of contact for PACE-enrolled participants, the participant's family, the Authorized Representative (AR), the caregiver, other authorized support person(s) as appropriate, and the interdisciplinary care team providing care to the participant. The Lead Care Manager supports the IDT by coordinating the Service Delivery Request process and documenting the meeting discussions. The PACE Lead Care Manager also provides direct assistance to participants by connecting them to PACE system of care and proactively reaches out to participants to resolve concerns to prevent disenrollment. Communicates appropriately to the interdisciplinary team members, management, and participants to resolve concerns. Promotes professional working relationships with both internal and external customers. Adheres to and supports all organizational policies and procedures and standards.

Responsibilities

PERFORMANCE AREA 1

• Serve as the primary point of contact for the Participant, Participant's family, Authorized Representative (AR), caregiver, other authorized support person(s) as appropriate, and the interdisciplinary care team providing care to the Participant.
• Manages a full participant caseload, with volumes determined by department leadership.
• Participate in IDT meetings and provide support to the IDT
• Scribes IDT meeting agenda and assists with coordinating meeting.
• Manages Service Delivery Requests to include initiation in EMR, documentation, NOA letters for denials, and service provided dates.
• Collaborates with health center scheduler for centralized assessment and transportation scheduling.
• Communicates a comprehensive Care Management Plan developed by the IDT with input from the Participant and/or their parent, caregiver, guardian.
• Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the Participant and non-duplication of services.
• Conducts ongoing outreach and engagement, primarily through in-person contact or the participant's preferred method of communication.
• Oversees provision of case management services and implements the participant's care plan.
• Manages referrals, and coordinates and follows up on needed services and supports.
• Organizes participant care activities and maintains at least monthly contact with their providers to ensure coordination, including referrals to specialty mental health.
• Advocates on behalf of the participant with health care professionals.
• Accompanies participant to office visits as needed.
• Monitors care plan adherence.
• Provides health promotion and self-management training and identifies support needs for a participant and their family or other caregivers.
• Supports the participant in making healthy choices and strengthening skills that allows the participant to better manage their conditions.
• Supports the participant and their personal support system during discharge from the hospital and other treatment facilities.
• Coordinates with hospital staff and skilled nursing facilities on discharge plan.
• Maintains courteous, helpful, and professional behavior on the job.
• Supports the success of the entire IDT team by promoting a collaborative work environment.
• Performs other duties that may be assigned.

PERFORMANCE AREA 2: General Corporate Expectations

• Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned.
• Attends workshops/seminars as necessary to increase skills and knowledge to provide effective care, treatment, and/or leadership.
• Supports the overall needs of the PACE Program by working flexible or extended hours when necessary.
• Supports the needs of the PACE Program by traveling to other UHC clinics when necessary.
• Demonstrates awareness of, and compliance with, organizational mission and objective of UHC to provide health care access and support services for all participants of the community.
• Other work-related duties as assigned by UHC PACE leadership. Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.
• Maintains confidentiality and respect for information regarding participants and other team participants; abides by UHC Rules of Confidentiality and general HIPAA regulations regarding privacy.
• Displays a positive, professional and respectful demeanor at all times toward employees, peers, professional contacts, and participants served, maintaining a professional appearance and positive image for the health centers.
• Contributes to the team by promoting positive staff interaction, maintains open communication with other programs/departments.

Qualifications

QUALIFICATION REQUIREMENTS:

• LVN license OR Medical Assistant (MA) certification OR additional education (i.e., Bachelor's degree) OR several years of progressive experience required (3+ years) is required.
• High school Diploma or GED required.

LICENSE/CERTIFICATION:

• Valid driver's license

PRIOR EXPERIENCE:

• 3+ years of progressive experience, preferred.

SKILLS:

• Bilingual (English/Spanish) required.
• Able to quickly build and maintain rapport with staff of differing backgrounds; team player
• Customer-service oriented
• Direct knowledge of the local community.
• Strong interest in the community and its people.
• Strong computer skills (knowledge of MS Office products and familiarity with medical management software)
• Positive professional insight
• Strong writing and verbal skills
• Flexibility and dependability
• Strong foundation of medical terminology
• Demonstrated good problem-solving skills; sound judgment
• Attention to detail and excellent follow-through on work tasks
• Able to handle multiple tasks simultaneously.

The hourly wage range that UHC reasonably expects to pay for the position upon hire starts at $26.62 an hour. Our salaries are dependent on knowledge, skills, and experience.

In addition, our comprehensive benefits package for regular status employees includes:

• Medical, Dental, and Vision insurance with low premium cost
• Paid time off and paid holidays
• 401k plan with matching contribution
• Educational Assistance
• Employee discounts and more!