Enhanced Care Management Program Manager

*ECM Program Manager
Pacific Health Group | Transforming Care Through Connection
At Pacific Health Group, we're more than just a healthcare organization—we're a catalyst for positive change. The
ECM Program Manager*
plays a pivotal role in ensuring that vulnerable individuals receive the care, support, and advocacy they need to live healthier, more stable lives. This position not only drives the operational excellence of our Enhanced Care Management (ECM) program but also empowers regional teams to deliver compassionate, person-centered care that directly improves outcomes for our members.

Through leadership, collaboration, and innovation, the ECM Program Manager enhances the quality of life for our communities while helping Pacific Health Group fulfill its mission to close health equity gaps and advance whole-person care across California.

Key Responsibilities

Team Leadership & Supervision

Purpose:
Empower care teams to deliver exceptional service that transforms member lives.

• Directly supervise and mentor Lead Care Managers across multiple assigned counties in California (Northern/Central regions)
• Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals
• Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion
• Meet in-person with each LCM within their region at least once per week or twice per month to maintain strong leadership presence, foster connection, and ensure program alignment
• Conduct regular performance evaluations and provide constructive feedback to optimize team performance
• Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress
• Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios
• Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations

Impact:
Builds a confident, mission-driven workforce that strengthens Pacific Health Group's reputation for excellence and compassion.

Program Development & Quality Assurance

Purpose:
Drive operational excellence and measurable health improvement.

• Establish comprehensive benchmarks and performance metrics for the ECM program
• Design and implement quality assurance protocols to monitor service delivery and member outcomes
• Develop standardized workflows and procedures to ensure consistency across counties
• Example: Create a dashboard tracking key performance indicators such as member engagement rates, hospital readmission reductions, and health outcome improvements with monthly reporting to stakeholders
• Example: Review staff performance metrics during weekly one-on-ones, identifying trends and providing real-time guidance for improvement opportunities
• Example: Use weekly team meetings to review program-wide performance data and collaboratively develop improvement strategies

Impact:
Enhances program accountability, improves care coordination, and delivers measurable results in health equity and member satisfaction.

Member Services Oversight

Purpose:
Ensure every member receives the right care, at the right time, in the right way.

• Ensure Lead Care Managers conduct regular in-person visits with ECM members
• Monitor frequency and quality of member interactions through documentation reviews and ride-alongs
• Implement strategies to improve member engagement and satisfaction
• Example: Institute a monthly audit process reviewing 10% of member files to verify appropriate in-person visit frequency, comprehensive assessment completion, and personalized care planning
• Example: Utilize weekly one-on-one meetings to review challenging member cases and collaboratively develop intervention strategies with Lead Care Managers
• Example: Dedicate time during weekly team meetings for case presentations of complex members, allowing for multi-perspective problem-solving and shared learning

Impact:
Improves outcomes, reduces hospital readmissions, and reinforces Pacific Health Group's reputation for compassionate, person-centered care.

Cross-Functional Collaboration

Purpose:
Build integrated partnerships that close gaps in the care continuum.

• Serve as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizations
• Collaborate with data analytics team to track program outcomes and identify improvement opportunities
• Partner with compliance department to ensure adherence to regulatory requirements
• Example: Establish quarterly collaborative meetings with hospital discharge planners to improve care transitions and reduce readmission rates for high-risk members
• Example: Provide updates during weekly team meetings on cross-departmental initiatives and partnership opportunities

Impact:
Strengthens organizational relationships, enhances service delivery, and positions Pacific Health Group as a trusted community health leader.

Budget & Resource Management

Purpose:
Steward organizational resources to maximize community impact.

• Develop and manage program budget, including staffing, operational costs, and member support resources
• Allocate resources efficiently across counties based on member needs and program priorities
• Track and report on program expenditures and return on investment
• Example: Create a resource allocation model that adjusts staffing levels based on member acuity and geographic considerations while maintaining cost-effectiveness

Impact:
Optimizes financial stewardship, enabling greater reinvestment in programs that directly support member well-being.

Program Innovation & Growth

Purpose:
Advance the future of care delivery through creativity and continuous improvement.

• Identify opportunities to enhance program effectiveness through innovative approaches
• Develop proposals for program expansion or new service offerings
• Stay current on industry best practices and integrate relevant approaches
• Example: Pilot a telehealth component to supplement in-person visits for rural members, evaluating impact on engagement and outcomes before regional implementation

Impact:
Shapes the evolution of Enhanced Care Management within Pacific Health Group, fostering scalable, sustainable solutions that expand access to care.

Additional Examples of ECM Program Manager Role

Weekly Meeting Management

• Design an effective weekly team meeting structure that balances operational updates, case reviews, professional development, and team building
• Rotate meeting facilitation responsibilities among Lead Care Managers to develop leadership skills across the team
• Implement a "bright spots" segment in weekly team meetings where staff share success stories and effective intervention strategies
• Use weekly team meetings as an opportunity to recognize staff achievements and celebrate program milestones

One-on-One Meeting Management

• Maintain a structured agenda template for weekly one-on-ones that includes caseload review, performance metrics discussion, professional development check-in, and resource needs assessment
• Document key discussion points and action items from each one-on-one meeting, with follow-up tracking to ensure completion
• Use these meetings to identify systemic issues that may require program-wide solutions or policy adjustments
• Develop individualized coaching approaches for each Lead Care Manager based on their learning style, experience level, and areas for growth

Team Leadership & Development

• Implement a structured mentorship program where you pair new Lead Care Managers with experienced ones across different counties to facilitate knowledge transfer and consistent practice standards
• Lead quarterly regional training sessions focused on complex case management strategies, addressing topics like managing members with co-occurring behavioral health and chronic medical conditions
• Create a cross-county peer learning community where Lead Care Managers can share best practices and problem-solve together

Operational Management

• Lead Monday morning operational huddles with all Lead Care Managers to review the week's priorities, address staffing challenges, and highlight critical member situations requiring attention
• Review and analyze weekly performance dashboards showing county-by-county metrics on member engagement, visit completion, and outcome measures
• Conduct bi-weekly case conferences focused on complex members who require multi-disciplinary approaches or have challenging barriers to engagement

Stakeholder Management

• Prepare and present quarterly program performance reports to health plan leadership, demonstrating impact on utilization, quality measures, and member outcomes
• Develop and maintain relationships with county behavioral health directors to improve coordination for members with mental health and substance use disorders
• Create and distribute a monthly ECM program newsletter highlighting success stories, best practices, and upcoming initiatives for internal and external stakeholders

Qualifications
Education & Experience

• Master's, or Bachelor's degree in Healthcare Administration, Public Health, Nursing, or related field
• 5+ years of experience in healthcare management, with at least 3 years in care/case management services
• Minimum of 2 years of direct experience working in Enhanced Care Management programs or equivalent intensive care management initiatives
• Demonstrated understanding of ECM program requirements, populations of focus, and care management best practices specific to high-need Medicaid populations
• Previous supervisory experience managing teams across multiple locations

Knowledge & Skills

• Thorough understanding of care management principles and practices
• Strong knowledge of healthcare delivery systems and Medicaid/Medicare programs
• In-depth familiarity with California's ECM program structure, reporting requirements, and quality metrics
• Experience interpreting and implementing ECM policy guidance and requirements from the Department of Health Care Services
• Excellent analytical skills to evaluate program effectiveness and implement improvements
• Advanced proficiency in healthcare data analysis and quality improvement methodologies

Personal Attributes

• Exceptional leadership abilities with demonstrated success in team development
• Strong communication and interpersonal skills
• Ability to manage multiple priorities in a fast-paced environment
• Commitment to person-centered care and health equity

Working Conditions

• Regular travel (50-60%) to county sites throughout California
• Occasional evening/weekend availability for special program initiatives or urgent situations

This position offers an opportunity to make a significant impact on vulnerable populations through innovative care management approaches while leading a dedicated team of healthcare professionals across California.

Compensation And Benefits
Job Type: Full-time

Pay: $80, $90,000.00 per year

Work Location: On the road

Benefits & Perks

• 160 Hours of Paid Time Off (PTO)
• 12 Paid Holidays per year, including your birthday and one floating holiday granted after 1 year of employment
• 4 Paid Volunteer Hours per Month to support causes you care about
• Bereavement Leave, including Fur Baby Bereavement
• 90% Employer-paid Employee-Only Medical Benefits
• FSA | Dependent Care Account
• 401(k) with Company Match
• Monthly Stipend
• Short-Term & Long-Term Disability | AD&D
• Employee Assistance Program (EAP)
• Employee Discounts via Great Work Perks and Perks at Work
• Quarterly In-Person Events
• Fully remote work within California
• Opportunities for professional development and internal growth

Equal Employment Opportunity

Pacific Health Group, along with its divisions, is a proud Equal Opportunity Employer. We embrace diversity and are devoted to creating an inclusive environment for all employees. Our commitment is to ensure equal employment opportunities for every qualified candidate, irrespective of race, religion, gender, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other status protected by federal, state, or local laws.

At Pacific Health Group, we recognize the importance of accessibility and are dedicated to provide reasonable accommodations for individuals with disabilities. We believe that our strength lies in our diversity, and we are committed to building a workforce that reflects the varied communities we serve. Join us in a workplace where everyone's contributions are valued and respected.

Pre-Employment Requirements

• Must reside within/adjacent to the Northern/Central California county regions assigned
• Employment is contingent upon the successful completion of a background check
• Possess a valid California Driver's License (Class C minimum), maintain a personal, operable vehicle for daily business use, and carry current liability insurance that meets California's minimum legal requirements. All selected candidates will be required to pass a Motor Vehicle Report (MVR) background check prior to employment

Please DO NOT contact employer regarding your application status, thank you

Job Application & Offer Disclaimer
Pacific Health Group is committed to maintaining a transparent, lawful, and secure hiring process in compliance with California labor laws and employment standards. No candidate will be offered employment without meeting the required qualifications and skillset for the position and successfully completing all steps of our recruitment process, which include:

• Submission of a completed internal application via our HRIS system
• A formal pre-screen with our recruiting team
• Completion of a skills assessment (if applicable to the position)
• Participation in a final interview with hiring leadership
• Receipt of a formal verbal offer from our authorized hiring team

  Important Notice: Any message, onboarding link, or communication that claims to represent Pacific Health Group but bypasses the steps listed above is not valid and not authorized by the company. Candidates are advised not to click on or respond to such messages. For verification, candidates may contact the Pacific Health Group Human Resources Department directly.

AI & Human Interaction (HI) in Recruitment
Pacific Health Group is committed to fairness, equity, and transparency in our hiring practices. We use
AI (Artificial Intelligence) tools
to help match candidate resumes against our job descriptions, focusing on qualifications, skillsets, and location.

All resumes that meet these criteria are then reviewed by
HI (Human Interaction)
— our recruiting and HR team. Pacific Health Group remains true to our
Equal Employment Opportunity (EEO) statement
, ensuring that every candidate is given fair and consistent consideration.

Requirements
Pre-Employment Requirements

• Must reside within/adjacent to the Northern/Central California county regions assigned
• Employment is contingent upon the successful completion of a background check
• Possess a valid California Driver's License (Class C minimum), maintain a personal, operable vehicle for daily business use, and carry current liability insurance that meets California's minimum legal requirements. All selected candidates will be required to pass a Motor Vehicle Report (MVR) background check prior to employment

Benefits
Benefits & Perks

• 160 Hours of Paid Time Off (PTO)
• 12 Paid Holidays per year, including your birthday and one floating holiday granted after 1 year of employment
• 4 Paid Volunteer Hours per Month to support causes you care about
• Bereavement Leave, including Fur Baby Bereavement
• 90% Employer-paid Employee-Only Medical Benefits
• FSA | Dependent Care Account
• 401(k) with Company Match
• Monthly Stipend
• Short-Term & Long-Term Disability | AD&D
• Employee Assistance Program (EAP)
• Employee Discounts via Great Work Perks and Perks at Work
• Quarterly In-Person Events
• Fully remote work within California
• Opportunities for professional development and internal growth