RN ECM Program Manager

AIDS Healthcare Foundation; Los Angeles (CA); On-site; USD 110,000 - 140,000; Full time

Job summary

AIDS Healthcare Foundation in Los Angeles is seeking an Enhanced Care Management Program Manager (ECMPM) to oversee ECM services, align with the CalAim model, and drive care coordination standards for improved health outcomes.

You will lead the ECM team, monitor outcomes, ensure regulatory compliance, advocate for health equity, and partner with leadership to achieve CMD goals; bilingual Spanish is a plus.

Qualifications

• CA RN license required; BSN preferred.
• Care management and managed care experience preferred.
• Bilingual Spanish preferred.

Responsibilities

• Provide day-to-day clinical oversight of ECM team members and collaborate with the interdisciplinary team.
• Monitor ECM and Community Supports utilization and drive solutions to improve member health outcomes and equity.
• Ensure compliance with CalAim regulatory requirements, CMD Model of Care, and related contracts.
• Support the achievement of CMD goals and company mission within a dynamic healthcare environment.

Skills

Leadership

Clinical knowledge

Care coordination

Regulatory compliance

Bilingual Spanish

Education

BSN preferred

Job description

A Enhanced Care Management Program Manager (ECMPM)
contributes to AHF by blending the Mission and Core Values with
care coordination processes and functions. The ECMPM provides
managerial oversight of the ECM Program, monitors Community
Supports utilization and is responsible for the establishment and
achievement of the Care Management Division (CMD) goals and
objectives for this program. The ECMPM collaborates with front line
team members and leadership to execute the Model of Care, meet
care coordination standards and maintain regulatory compliance;
thereby, improving health outcomes, promoting health equity,
overcoming Social Determinants of Health (SDOH) barriers, and
improving patient satisfaction and retention rates. The ECMPM
demonstrates strong leadership skills, clinical skills, proactive
thinking, comprehensive knowledge of healthcare rules and
supportive services, with a special focus dedicated to HIV/AIDS
members, ensuring that all members have access to a
comprehensive set of services based on their needs and preferences
across the continuum of care.
A ECMPM enhances the reputation of AHF by maintaining the AHF
Management Philosophy principles, which is inclusive of the
following elements: Mission Driven, Fairness, Learning, Hands On,
Accountability and Tenacity. The ECMPM also utilizes core principles
of nursing to meet members where they are, identify strengths and Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the world. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.
barriers, and assist with realistic goal setting to improve member health outcomes, health equity, and quality of life. You will be a passionate advocate for our top initiatives. To be successful as a ECMPM it is crucial to ensure that the AHF Core Values and Mission stay top of mind with all that you do. At AHF we are nimble and able to adapt in a dynamic environment to assist in providing the best experience for our clients and workplace for our employees. AHF has a collaborative organizational structure where staff are accountable to multiple leaders. The ECMPM will work as a part of a close-knit team to maintain a comprehensive knowledge of the DHCS CalAim regulatory requirements, the CMD Model of Care, Health Plan Accreditation Standards, and county/state regulations and guidance, including All Plan Letters and contract deliverables, and provide updates to the team on a routine basis. The ECMPM provides day-to-day clinical oversight of ECM team members and works with the interdisciplinary team to analyze member outcomes, evaluate the utilization of ECM and Community Supports benefits and develop solutions to improve both member health outcomes, while demonstrating a caring and compassionate focus. Licenses and Certifications: CA RN License required; BSN preferred Acute care experience preferred Care Management experience preferred Managed Care experience preferred Bilingual Spanish preferred