Hybrid Community Support Lead Care Manager

at Pacific Health Group

• Job title: Community Support Lead Care Manager
• Job type: Full Time
• Experience level: Senior
• Salary: $27 - $32 per hour
• Degree requirement: No Education Requirement
• Location requirements: Hybrid, Santa Clara, United States

About the role

• Community Supports Lead Case Manager at Pacific Health Group handling care for Medi-Cal members in California. Guiding members through comprehensive care coordination and advocacy.

Responsibilities

• Conduct comprehensive evaluations of members’ needs, preferences, and eligibility through detailed conversations and data review.
• Develop tailored care plans based on individual health and social circumstances.
• Arrange all aspects of member care, including scheduling appointments, organizing follow-up services, and linking members to community resources.
• Ensure members receive consistent, end-to-end support for long-term stability and health improvement.
• Perform empathetic assessments that capture members’ lived experiences and goals, not just medical data.
• Maintain close communication with members via phone, video, or in-person visits to monitor progress and address emerging challenges.
• Serve as a bridge between members and available community resources, such as housing programs, workforce training, childcare, and food assistance.
• Advocate for timely treatments, fair insurance authorizations, and equitable access to care.
• Act as the central communication hub among members, their families, healthcare providers, and community partners.
• Maintain accurate, up-to-date documentation of assessments, care plans, progress notes, and outcomes.
• Collect and analyze feedback to identify gaps in care coordination and advocate for new resources or partnerships.
• Remain current on Medi-Cal, CalAIM, and community support policies to ensure all activities meet compliance and quality-of-care standards.
• Participate in workshops, training, and certifications on cultural competence, trauma-informed care, and motivational interviewing.
• Provide mentorship, guidance, and day-to-day support to other Care Managers within the Community Supports Program.
• Assist in onboarding new team members and promoting a collaborative, compassionate care environment.
• Support program initiatives and special projects as assigned.

Requirements

• Experience: 3–5 years in case management, social services, or healthcare.
• Expertise: Familiarity with Medi-Cal, CalAIM, and Community Supports programs.
• Healthcare Insight: Knowledge of healthcare systems, managed care operations, and local community resources.
• Interpersonal Skills: Strong communication, empathy, cultural competence, and teamwork.
• Organizational Skills: Proven time management and attention to detail.
• Technical Proficiency: Competence in using case management software, EHR systems, and related tools.