Case Manager

The Lead Care Manager (LCM) joins the Enhanced Care Management (ECM) team and serves as the client's primary point of contact, working with all their providers such as doctors, specialists, pharmacists, social services providers, and others to make sure everyone is in agreement about the client's needs and care. The LCM manages client cases, coordinates health care benefits, provides education and facilitates member access to care in a timely and cost-effective manner. This is a field-based position that requires traveling throughout the Humboldt County area up to 5 days per week. Candidates must reside within a 20 miles radius of the assigned territory. This is a critical role that the company is looking to fill as soon as possible.

Responsibilities

Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports; Oversee the development of client care plans and goal settings; Offer services where the member resides, seeks care, or finds most easily accessible, including office-based, telehealth, or field-based services; Connect clients to other social services and supports that are needed; Advocate on behalf of the client with health care professionals (e.g. PCP, etc.); Utilize evidence-based practices, such as Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles; Conduct outreach and engagement activities to facilitate linkage to the ECM program and log activity in the Client Relationship Management (CRM) system; Evaluate client's progress and update SMART goals; Provide mental health promotion; Arrange transportation (e.g., ACCESS); Complete all documentation, including outcome measures within the timeframes established by the individual care plans; Maintain up-to-date patient health records in the Electronic Medical Record (EMR) system and other business systems; Complete monthly reporting to ensure program compliance; Attend training as assigned

Requirements

2+ years experience as a care manager, care navigator, or community health worker supporting vulnerable populations; Willing and able to visit member homes and community locations as needed to support field-based ECM services, including visiting housing shelters and treatment centers; Willing and able to work Monday-Friday 8:30am-5:00pm Pacific Time, both in the field and remotely, with flexibility for potential evenings and weekends; Working knowledge of government and community resources related to social determinants of health; Valid driver's license and reliable transportation; Excellent oral and written communication skills; Positive interpersonal skills required; Must have general computer skills and a working knowledge of Google Workspace, MS Office and the internet

Nice to have

Bilingual (English/Spanish), strongly preferred