Senior ECM Care Lead for Complex Needs

Whole Person Care Clinic; Santa Ana (CA); On-site; USD 90,000 - 130,000; Full time

Job summary

National Healthcare & Housing Advisors (NHHA) seeks an ECM Lead Care Manager to coordinate and oversee Enhanced Care Management for individuals with complex medical, behavioral health, and social needs. You will guide care teams, ensure adherence to workflows, and drive person-centered service delivery across partners.

You will lead assessments, develop comprehensive care plans, monitor outcomes, and support staff with coaching and continuous quality improvement efforts.

Qualifications

• Medical background with appropriate training and oversight.
• Knowledgeable in medical terminology and client care practices.
• Excellent verbal and interpersonal communication skills.
• Strong organizational skills for coordinating care between clients and their care team.
• Ability to work independently and make decisions in a fast-paced environment.
• Experienced with electronic health record (EHR) systems.

Responsibilities

• Coordinate with individuals and entities to ensure seamless experiences and avoid duplication of services.
• Outreach to clients for ECM services and provide care coordination where needed.
• Connect clients to social services and transportation.
• Develop and oversee comprehensive care plans addressing medical, mental health, and social needs.
• Coordinate and advocate on behalf of clients with healthcare providers, social services, and community resources.
• Conduct regular assessments of client progress and adjust care plans as needed.
• Monitor client care outcomes and lead quality improvement initiatives.
• Accompany clients to office visits as needed and according to health plan guidelines.
• Monitor treatment adherence (including medication).
• Use motivational interviewing, trauma-informed care, and harm-reduction approaches.
• Provide health promotion and self-management training.
• Foster relationships with providers and stakeholders to enhance collaborative care.
• Act as liaison between clients, families, and healthcare teams for effective communication.
• Participate in multidisciplinary team meetings and case conferences.
• Identify opportunities for program development and implement innovative care management strategies.

Skills

Verbal and interpersonal communication

Organizational skills

Independent decision-making

Care coordination

Education

Medical background with oversight

Knowledge of medical terminology and client care practices

Tools

Electronic health record (EHR) systems

Job description

National Healthcare & Housing Advisors (NHHA) seeks an ECM Lead Care Manager to coordinate and oversee Enhanced Care Management for individuals with complex medical, behavioral health, and social needs. You will guide care teams, ensure adherence to workflows, and drive person-centered service delivery across partners.

You will lead assessments, develop comprehensive care plans, monitor outcomes, and support staff with coaching and continuous quality improvement efforts.