Enhanced Care Services Lead
$72,000–$79,373 year
On-sitePomona, California, United States
Job Summary
Lead daily operations for the Enhanced Care Management program by supporting the Mental Health Director with workflow optimization, documentation compliance, and reimbursement support while maintaining an active caseload of approximately 30 members. Guide ECM Care Managers on care coordination and program processes, conduct peer documentation audits, and ensure adherence to DHCS and Managed Care Plan guidelines. Coordinate comprehensive services for ECM members, prepare Return Transmission and Outreach Tracker files, and monitor enrollment and monthly reporting requirements. Collaborate with providers, internal departments, and community partners to connect members to medical and behavioral health resources. Assist in training staff, preparing productivity reports, and implementing quality improvement initiatives to enhance program performance.
Required Qualifications
- Bachelor's degree in social work, Public Health, Human Services, Nursing, or a related field
- Minimum of two (2) years of experience in care management, case management, behavioral health, population health, or a related healthcare setting
- Strong organizational, problem-solving, and communication skills
- Ability to prioritize multiple responsibilities and collaborate effectively with multidisciplinary teams
- Proficiency in Microsoft Office and electronic health record (EHR) systems
Desired Qualifications
- Bachelor's degree in social work, Public Health, Human Services, Nursing, or a related field preferred
- Equivalent combination of education and experience may be considered
- Experience with Enhanced Care Management (ECM), CalAIM, Medi-Cal Managed Care, or care coordination programs preferred
- Demonstrated ability to mentor peers, coordinate workflows, or support quality improvement initiatives preferred
- NextGen experience preferred
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