Supervisor, Care Management (Enhanced Care Management)

Supervisor, Care Management

HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

This is a field-based position, requiring frequent travel. Primary service area : Orange County (may expand to neighboring counties as needed).

CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and payment reforms across the Medi-Cal program. A key feature of CalAIM is the statewide introduction of an Enhanced Care Management (ECM) benefit and a menu of Community Supports, which, at the option of a Managed Care Plan (MCP), publicly funded health insurance plans for low-income citizens, can address the clinical and non-clinical needs of Populations of Focus with the most complex medical and social needs.

The Supervisor, Care Management will be responsible for overseeing the ECM program to serve members under the Managed Care Plan (MCP) by providing care by linking clients with appropriate services to address specific needs such as physical and mental health, substance use disorder, (residential and outpatient) employment, Justice-Involved concerns, housing, community resources, and aftercare. The Supervisor, Care Management is required to identify and engage with each member in the community, including the member's home, service provider locations and other, various locations requiring outreach. The Supervisor, Care Management will also hire, supervise, and train new staff incrementally, as the program grows to serve the expanding population.

Key Responsibilities :

• Organize, stabilize, and integrate the new project by meeting with representatives from the funding source (e.g., CalOptima or other local MCPs).
• Understand the needs of the population, referral and authorization processes, data-entry, and billing, to build a solid foundation for the program.
• Create a framework that allows for community-based program expansion.
• Organize patient care activities as outlined by the MCP and implement identified care coordination strategies.

Client Identification & Engagement :

In-person meetings at the client's location

Care Coordination & Case Management :

Primary care

Medication coordination and reconciliation

Assessment & Client Support :

Medical and behavioral healthcare

Team Collaboration :

Clinical Documentation :

Training, Supervision, and Quality Improvement Responsibilities :

Work Environment :

Homes

Qualifications :

Desired :