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Enhanced Care Management Lead

2 months ago

Escondido, United States Neighborhood Healthcare Full time
Job DescriptionJob Description

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 506,563 medical, dental, and behavioral health visits from more than 96,867 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

The Enhanced Care Management Lead will assist in program development and implementation of the care management operations for the ECM Program and patients. This role will support and oversee the daily operational and administrative activities of the care management teams.

Responsibilities

  • Primary role will be training and mentoring of staff and responding to daily questions.
  • Works with management to ensure the ECM operations is running smoothly and production goals are met
  • Works with leadership, providers, and managed care teams to determine the needs of a high-utilizer and vulnerable patient populations, such as basic housing assistance and patient tailored intensive case management
  • Develops care and service plans with linkages to medical, psychiatric, social, educational, and other services, as needed
  • Works with community-based organizations to provide team-based and patient-centered care management for ECM patients
  • Provides support to the ECM Supervisor by assisting with daily operations, such as managing staffing schedules, calendaring, and liaising with community partners
  • Builds positive staff relationships, inspires others to perform at a higher level, and retains an accountable workforce
  • Facilitates meetings and trainings with ECM teams to provide updates and develop strategies for program quality assurance, quality improvement, and compliance by following Neighborhood/program policies and procedures
  • Recommends decisions to hire, transfer, reward, discipline or terminate employees
  • Assess training needs and promote developmental activities
  • Oversees, reviews, and audits case files; provides prompt/actionable feedback to ECM team members
  • Conducts outreach, enrollment, monthly reporting, and accurate completion of comprehensive risk assessments and care plans
  • Conducts proper intake steps such as patient data collection, eligibility, program enrollment, care plan development, and assessment of needs
  • Provides direct care management services to ECM participants in their assigned caseload in line with ECM guidelines and recommended services
  • Responds to patient inquiries and refers patients to other departments, social services, or support services, as needed
  • Assists members in navigating the healthcare system by finding and following up by phone and in-person with eligible ECM members
  • Helps members participate in their medical and/or behavioral healthcare by overcoming barriers to care
  • Documents and shares member barriers with ECM team and PCP to improve care and outcomes
  • Works collaboratively within the ECM team to discuss responsibilities, task sharing, conflict resolution, and member case reviews
  • Collaborates on member care issues with other ECM team members
  • Participates in weekly case reviews and consults with the member's PCP after taking any clinical action
  • Ensures documentation is accurate, helpful, and compliant with regulatory requirements and accreditation standards
  • Participates in required staff meetings or other activities

Quality Management & Record Keeping

  • Contributes to the success of the organization by participating in quality improvement activities
  • Documents in eClinicalWorks (eCW) for all care coordination, including services or teachings provided
  • Prioritizes activities according to intensity, need, and required follow-up
  • Provides accurate and timely reports to supervisor and manager, as required

Qualifications

Education/Experience

  • High school/GED required
  • Two years community outreach or behavioral health experience working with high-risk populations required
  • Experience working with the patient centered medical home preferred
  • Experience working within behavioral health, integrated primary care, or federally qualified health center (FQHC) settings preferred
  • Bilingual (English/Spanish) preferred
  • Lead experience preferred; completion of LEAP preferred (internal)
  • Valid CA driver’s license and proof of auto insurance required

Additional Qualifications (Knowledge, Skills and Abilities)

  • Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
  • Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
  • Knowledgeable about and experience with various characteristics of homeless adult populations, seniors, or other vulnerable populations
  • Knowledgeable about and experience with experience with issues of mental illness and/or chemical dependency
  • Knowledgeable about and experience with computer programs, such as Microsoft applications and electronic medical records
  • Ability to be sensitive and understand the emotions of others
  • Ability to demonstrate management of their own emotions and impulses
  • Ability to train and develop staff
  • Ability to successfully manage multiple tasks simultaneously
  • Ability to work with people of all social and ethnic backgrounds
  • Excellent planning and organizational ability
  • Ability to work as part of a team as well as independently
  • Ability to work with highly confidential information in a professional and ethical manner

Physical Requirements

  • Ability to lift/carry 25 lbs/weight
  • Ability to stand for long periods of time

Pay range: $26.72-$34.13 per hour, depending on experience.