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Lead Care Manager - Santa Clara County (Milpitas)
Pacific Health Group - Milpitas, CA
posted 3 months ago
About the position
The Community Supports Lead Case Manager at Pacific Health Group plays a crucial role in transforming healthcare by coordinating access to community-based services for Medi-Cal beneficiaries. This position focuses on improving health outcomes by addressing social determinants of health and ensuring that patients receive the necessary care and support. The role emphasizes leadership, collaboration, and innovation in a dynamic environment dedicated to making a positive impact on the lives of individuals in need.
Responsibilities
- Lead the orchestration of comprehensive care plans, ensuring seamless integration of services across various healthcare providers and organizations.
- Assess individual patient needs, develop tailored care plans, and manage cases with a focus on delivering essential medical, social, and support services, including ongoing Telehealth communication.
- Conduct regular in-person visits to members to assess their needs, provide support, and ensure the effective delivery of care services.
- Strategically identify and optimize resources to meet the unique needs of patients and their families.
- Advocate for patients, safeguarding their rights, preferences, and best interests throughout their care journey.
- Serve as the central hub of communication, ensuring a smooth exchange of information among patients, families, healthcare providers, and all involved parties.
- Maintain meticulous and up-to-date records of assessments, care plans, progress notes, and other vital documentation, adhering to both legal and organizational standards.
- Analyze data, spot opportunities for enhancement, and implement strategies to elevate the quality and efficiency of care management services.
- Stay informed about relevant laws, regulations, and policies, ensuring compliance in care delivery.
- Engage in ongoing training and professional development to stay ahead of industry trends.
Requirements
- 2+ years of experience in case management, social services, or healthcare.
- In-depth knowledge of Medi-Cal, CalAIM, and the 14 Community Supports.
- Familiarity with healthcare systems and community resources.
- Strong interpersonal and communication skills.
- Exceptional organizational and time management abilities.
- Proficiency in case management software and tools.
- Cultural competence and sensitivity to diverse populations.
Nice-to-haves
- Needs assessment and care planning
- Service coordination and navigation
- Client advocacy
- Motivational interviewing
- Data management and reporting
- Problem-solving and decision-making
- Teamwork and collaboration
Benefits
- 401(k)
- 401(k) matching
- AD&D insurance
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance (90% of Employee Only benefits covered by the company)
- Vision insurance
- Short-term and Long-term Disability
- Employer Paid Disability
- Legal Insurance with access to a nationwide network of more than 14,000 participating plan attorneys
- Unlimited PTO
- 12 holidays per year, including your birthday, and one floating holiday after 1 year of employment
- Paid sick time
