Enhanced Care Management (ECM) Program Manager Hybrid Northern CA

Job Description

Job Description

Pacific Health Group is seeking an experienced Enhanced Care Management (ECM) Program Manager to lead a dedicated team of Care Managers across multiple Northern California counties. This individual will drive program development, ensure quality service delivery, and collaborate with diverse healthcare partners to improve outcomes for high-need Medicaid populations.

Key Responsibilities

Team Leadership & Supervision

Directly supervise and mentor Lead Care Managers in multiple counties

Conduct weekly one-on-one meetings to provide individualized guidance, address challenges, and align on program goals

Facilitate weekly team meetings to promote collaboration, share updates, and foster team cohesion

Perform regular performance evaluations, offering constructive feedback to optimize team effectiveness

Example : Develop individualized professional development plans for each Lead Care Manager and conduct quarterly check-ins to track growth.

Program Development & Quality Assurance

Establish comprehensive benchmarks and performance metrics for the ECM program

Design and implement quality assurance protocols to monitor service delivery and member outcomes

Create standardized workflows and procedures to ensure consistency across counties

Example : Maintain a dashboard of key performance indicators (for instance, member engagement and hospital readmission rates) and share reports with stakeholders.

Member Services Oversight

Ensure Lead Care Managers conduct regular in-person visits with ECM members

Monitor member interactions through documentation reviews and occasional ride-alongs

Implement strategies to improve member engagement and satisfaction

Example : Audit a sample of member files each month to verify in-person visit frequency, comprehensive assessments, and personalized care plans.

Cross-Functional Collaboration

Serve as primary liaison between the ECM program and healthcare partners, including hospitals and community organizations

Work closely with data analytics to track outcomes and identify improvement opportunities

Partner with compliance to ensure adherence to regulatory requirements

Example : Organize collaborative meetings with hospital discharge planners to coordinate care transitions and reduce readmission risks.

Budget & Resource Management

Develop and manage the program budget, including staffing, operational costs, and resource needs

Allocate resources efficiently based on member acuity and county priorities

Track and report on program expenditures and return on investment

Example : Create a staffing model that adjusts resource levels based on geographic demands and member needs.

Program Innovation & Growth

Identify and implement innovative approaches to enhance program effectiveness

Propose strategies for program expansion or new service offerings

Stay updated on industry best practices and integrate relevant methods into the ECM program

Example : Pilot a telehealth component to supplement in-person visits for rural members, measuring impact on engagement and outcomes.

Qualifications

Education & Experience

Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or a related field

Five or more years of healthcare management experience, with at least three years in care management

Minimum of two years of direct experience in ECM programs or equivalent intensive care management initiatives

Demonstrated understanding of ECM program requirements, populations of focus, and best practices for high-need Medicaid populations

Proven supervisory experience managing teams across multiple locations

Knowledge & Skills

Thorough knowledge of care management principles and practices

Strong familiarity with healthcare delivery systems and Medicaid or Medicare programs

Expertise in California’s ECM structure, including reporting requirements and quality metrics

Ability to interpret and implement ECM policy guidance from the Department of Health Care Services

Excellent analytical and quality improvement skills, with the ability to leverage healthcare data

Advanced leadership, communication, and interpersonal abilities

Personal Attributes

Exceptional leadership and team-building skills

Strong communication and organizational abilities

Ability to manage multiple priorities in a fast-paced environment

Commitment to person-centered care and health equity

Working Conditions

Primary office based in Sacramento

Regular travel (approximately thirty to forty percent) to county sites across Northern California

Occasional evening or weekend availability for special initiatives or urgent program needs

Benefits

401(k)

Dental Insurance

Health Insurance

Vision Insurance

Life Insurance

Paid Time Off (PTO)

Why Join Pacific Health Group?

Impactful Work : Make a tangible difference in the lives of vulnerable populations through advanced care management.

Leadership Opportunity : Oversee a multi-county team, mentor emerging leaders, and shape an ECM program recognized for quality and innovation.

Growth & Development : Access ongoing professional development and the opportunity to pioneer new initiatives in a rapidly evolving healthcare landscape.