Lead Case Manager in Enhanced Care Management addressing social determinants of health. Support members through comprehensive care coordination and active community engagement in San Benito County.
About the role
- Community Support Lead Care Manager role helping Medi-Cal members through care plans and support. Assist families and bridge health-related social needs in community settings.
Responsibilities
- Manage a caseload of members with complex health and social needs
- Spend approximately 65% of your time in the field (homes, shelters, community settings)
- Conduct in-person visits, assessments, and follow-ups
- Travel locally within Santa Clara County
- Coordinate services across healthcare, behavioral health, and community resources
- Participate in community outreach efforts including events, partnerships, and local engagement
- Provide mentorship and support to other care managers
- Document in real-time or by end of day using internal systems
- Conduct comprehensive member assessments to identify health and social needs
- Develop and manage individualized care plans
- Coordinate appointments, services, and long-term support systems
- Ensure continuity of care and consistent follow-through
- Build strong, trusting relationships with members and their families
- Provide ongoing support through phone, video, and in-person visits
- Advocate for timely care, services, and equitable access to resources
- Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives
- Build and maintain relationships with community-based organizations, shelters, and service providers
- Identify opportunities to expand community presence and improve access to services
- Connect members to housing, food access, workforce programs, childcare, and other services
- Strengthen partnerships with community-based organizations
- Identify gaps in resources and escalate needs for program improvement
- Provide guidance, mentorship, and support to care managers within the program
- Assist with onboarding and training of new team members
- Maintain accurate and timely documentation of all member interactions
- Ensure compliance with Medi-Cal, CalAIM, and Community Supports program requirements
- Track progress, outcomes, and service delivery
- Partner with interdisciplinary teams including behavioral health, outreach, and social services
- Coordinate with healthcare providers and payers to ensure seamless care delivery
- Identify trends and gaps in services
- Provide feedback to leadership to improve care coordination strategies and partnerships
Requirements
- Experience: 3–5 years in case management, social services, or healthcare
- Experience with: Medi-Cal, CalAIM, and Community Supports programs (preferred)
- Strong understanding of healthcare systems, managed care, and community resources
- Excellent communication, empathy, and cultural competence
- Strong organizational and time management skills
- Must be proficient in technology, including case management systems, EHR platforms, and documentation tools
- Ability to document in real-time and manage member data accurately
- Comfortable navigating multiple systems and communication platforms
- Ability to travel locally within Santa Clara County
- Valid California Driver’s License and reliable transportation
- Ability to work in a hybrid, field-based environment
Benefits
- Hourly Range:$30.00 - $35.00, depending on experience, qualifications, and internal equity
- Monthly stipend
- 160 hours PTO + paid sick time
- 11 paid holidays (including birthday and floating holiday)
- 4 paid volunteer hours per month
- 90% employer-paid employee-only medical benefits
- Flexible Spending Account (FSA)
- Short-term & long-term disability, AD&D
- Employee Assistance Program (EAP)
- 401(k) with company match
- Professional development opportunities
- Quarterly in-person events
- Employee discount programs
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