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Lead for Enhanced Care Management

2 months ago

Escondido, California, United States Neighborhood Healthcare Full time
Job Overview

At Neighborhood Healthcare, we believe in a holistic approach to community health, emphasizing the importance of resources that empower individuals to thrive. Our mission is to foster a community where everyone can achieve optimal health and happiness. With a history dating back to 1969, we are dedicated to providing quality care to all, irrespective of their circumstances.

The Enhanced Care Management Lead plays a pivotal role in the development and execution of care management strategies within the ECM Program. This position is essential for overseeing the daily operational and administrative functions of the care management teams.

Key Responsibilities

  • Facilitate training and mentorship for staff while addressing daily inquiries.
  • Collaborate with management to ensure smooth ECM operations and achievement of production targets.
  • Engage with leadership, healthcare providers, and managed care teams to assess the needs of high-utilizer and vulnerable patient populations, including assistance with housing and intensive case management.
  • Formulate care and service plans that connect patients to medical, psychiatric, social, educational, and other necessary services.
  • Partner with community organizations to deliver team-oriented and patient-focused care management for ECM patients.
  • Support the ECM Supervisor with daily operations, including managing staffing schedules and liaising with community partners.
  • Foster positive relationships among staff, encouraging high performance and accountability.
  • Conduct meetings and training sessions with ECM teams to provide updates and develop strategies for quality assurance and compliance.
  • Advise on personnel decisions regarding hiring, transfers, rewards, and disciplinary actions.
  • Evaluate training needs and promote professional development opportunities.
  • Oversee and audit case files, providing timely and actionable feedback to team members.
  • Manage outreach, enrollment, and accurate completion of comprehensive risk assessments and care plans.
  • Implement proper intake procedures, including data collection, eligibility verification, and care plan development.
  • Deliver direct care management services to ECM participants in accordance with established guidelines.
  • Address patient inquiries and refer them to appropriate departments or services as necessary.
  • Assist members in navigating the healthcare system and following up with eligible ECM participants.
  • Support members in engaging with their medical and behavioral healthcare by addressing barriers to access.
  • Document and communicate member barriers to the ECM team and primary care providers to enhance care outcomes.
  • Collaborate with the ECM team to discuss responsibilities, task sharing, and member case reviews.
  • Participate in weekly case reviews and consult with primary care providers following clinical actions.
  • Ensure documentation is accurate and compliant with regulatory standards.
  • Engage in required staff meetings and other organizational activities.

Quality Management & Record Keeping

  • Contribute to organizational success through participation in quality improvement initiatives.
  • Document all care coordination activities in the electronic medical record system.
  • Prioritize tasks based on urgency and follow-up requirements.
  • Provide timely reports to supervisors and management as needed.

Qualifications

Education and Experience

  • High school diploma or GED required.
  • Minimum of two years of experience in community outreach or behavioral health with high-risk populations.
  • Experience in patient-centered medical homes is preferred.
  • Experience in behavioral health, integrated primary care, or federally qualified health centers is preferred.
  • Bilingual in English and Spanish is preferred.
  • Previous leadership experience is preferred; completion of internal leadership training is a plus.
  • Valid driver's license and proof of auto insurance are required.

Additional Skills and Abilities

  • Exceptional verbal and written communication skills.
  • Ability to interpret various forms of instructions.
  • Knowledge of the characteristics of vulnerable populations, including those experiencing homelessness or mental health issues.
  • Proficient in Microsoft applications and electronic medical records.
  • Capacity to manage multiple tasks effectively.
  • Ability to work collaboratively and independently.
  • Maintain confidentiality in a professional manner.

Physical Requirements

  • Ability to lift and carry up to 25 lbs.
  • Ability to stand for extended periods.

Compensation: $26.72-$34.13 per hour, based on experience.