Enhanced Care Management

PACIFIC HEALTH GROUP is seeking an experienced Enhanced Care Management (ECM) Program Manager to lead a dedicated team of Care Managers across multiple Northern California counties. This individual will drive program development, ensure quality service delivery, and collaborate with diverse healthcare partners to improve outcomes for high-need Medicaid populations. Responsibilities Team Leadership & Supervision Directly supervise and mentor Lead Care Managers in multiple counties Conduct weekly one-on-one meetings to provide guidance, address challenges, and align on program goals Facilitate weekly team meetings to promote collaboration, share updates, and foster cohesion Perform regular performance evaluations, offering constructive feedback to optimize team effectiveness Example: Develop individualized professional development plans for each Lead Care Manager and conduct quarterly check‑ins to track growth. Program Development & Quality Assurance Establish comprehensive benchmarks and performance metrics for the ECM program Design and implement quality assurance protocols to monitor service delivery and member outcomes Create standardized workflows and procedures to ensure consistency across counties Example: Maintain a dashboard of key performance indicators (e.g., member engagement and hospital readmission rates) and share reports with stakeholders. Member Services Oversight Ensure Lead Care Managers conduct regular in‑person visits with ECM members Monitor member interactions through documentation reviews and occasional ride‑alongs Implement strategies to improve member engagement and satisfaction Example: Audit a sample of member files each month to verify in‑person visit frequency, comprehensive assessments, and personalized care plans. Cross‑Functional Collaboration Serve as primary liaison between the ECM program and healthcare partners, including hospitals and community organizations Work closely with data analytics to track outcomes and identify improvement opportunities Partner with compliance to ensure adherence to regulatory requirements Example: Organize collaborative meetings with hospital discharge planners to coordinate care transitions and reduce readmission risks. Budget & Resource Management Develop and manage the program budget, including staffing, operational costs, and resource needs Allocate resources efficiently based on member acuity and county priorities Track and report on program expenditures and return on investment Example: Create a staffing model that adjusts resource levels based on geographic demands and member needs. Program Innovation & Growth Identify and implement innovative approaches to enhance program effectiveness Propose strategies for program expansion or new service offerings Stay updated on industry best practices and integrate relevant methods into the ECM program Example: Pilot a telehealth component to supplement in‑person visits for rural members, measuring impact on engagement and outcomes. Qualifications Education & Experience Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or a related field Five or more years of healthcare management experience, with at least three years in care management Minimum of two years of direct experience in ECM programs or equivalent intensive care management initiatives Proven supervisory experience managing teams across multiple locations Knowledge & Skills Thorough knowledge of care management principles and practices Strong familiarity with healthcare delivery systems and Medicaid or Medicare programs Expertise in California’s ECM structure, including reporting requirements and quality metrics Ability to interpret and implement ECM policy guidance from the Department of Health Care Services Excellent analytical and quality improvement skills, with ability to leverage healthcare data Advanced leadership, communication, and interpersonal abilities Personal Attributes Exceptional leadership and team‑building skills Strong communication and organizational abilities Ability to manage multiple priorities in a fast‑paced environment Commitment to person‑centered care and health equity Working Conditions Primary office based in Sacramento. Regular travel (approximately 30–40%) to county sites across Northern California. Occasional evening or weekend availability for special initiatives or urgent program needs. Benefits 401(k) Dental Insurance Health Insurance Vision Insurance Life Insurance Paid Time Off (PTO) Why Join Pacific Health Group? Impactful Work: Make a tangible difference in the lives of vulnerable populations through advanced care management. Leadership Opportunity: Oversee a multi‑county team, mentor emerging leaders, and shape an ECM program recognized for quality and innovation. Growth & Development: Access ongoing professional development and the opportunity to pioneer new initiatives in a rapidly evolving healthcare landscape. If you are interested in applying for this job please press the Apply Button and follow the application process. Energy Jobline wishes you the very best of luck in your next career move. #J-18808-Ljbffr