ECM - Lead Care Program Manager - Southern California ...

Enhanced Care Management Program Manager (Southern California)Join to apply for the Enhanced Care Management Program Manager (Southern California) role at Pacific Health GroupEnhanced Care Management Program Manager (Southern California)3 days ago Be among the first 25 applicantsJoin to apply for the Enhanced Care Management Program Manager (Southern California) role at Pacific Health GroupECM Program Manager at Pacific Health GroupDirectly supervise and mentor Lead Care Managers across multiple counties in Southern CaliforniaConduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goalsFacilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesionConduct regular performance evaluations and provide constructive feedback to optimize team performanceExample: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progressExample: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenariosExample: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situationsJob DescriptionECM Program Manager at Pacific Health GroupKey ResponsibilitiesTeam Leadership & SupervisionDirectly supervise and mentor Lead Care Managers across multiple counties in Southern CaliforniaConduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goalsFacilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesionConduct regular performance evaluations and provide constructive feedback to optimize team performanceExample: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progressExample: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenariosExample: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situationsProgram Development & Quality AssuranceEstablish comprehensive benchmarks and performance metrics for the ECM programDesign and implement quality assurance protocols to monitor service delivery and member outcomesDevelop standardized workflows and procedures to ensure consistency across countiesExample: Create a dashboard tracking key performance indicators such as member engagement rates, hospital readmission reductions, and health outcome improvements with monthly reporting to stakeholdersExample: Review staff performance metrics during weekly one-on-ones, identifying trends and providing real-time guidance for improvement opportunitiesExample: Use weekly team meetings to review program-wide performance data and collaboratively develop improvement strategiesMember Services OversightEnsure Lead Care Managers conduct regular in-person visits with ECM membersMonitor frequency and quality of member interactions through documentation reviews and ride-alongsImplement strategies to improve member engagement and satisfactionExample: Institute a monthly audit process reviewing 10% of member files to verify appropriate in-person visit frequency, comprehensive assessment completion, and personalized care planningExample: Utilize weekly one-on-one meetings to review challenging member cases and collaboratively develop intervention strategies with Lead Care ManagersExample: Dedicate time during weekly team meetings for case presentations of complex members, allowing for multi-perspective problem-solving and shared learningCross-Functional CollaborationServe as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizationsCollaborate with data analytics team to track program outcomes and identify improvement opportunitiesPartner with compliance department to ensure adherence to regulatory requirementsExample: Establish quarterly collaborative meetings with hospital discharge planners to improve care transitions and reduce readmission rates for high-risk membersExample: Provide updates during weekly team meetings on cross-departmental initiatives and partnership opportunitiesBudget & Resource ManagementDevelop and manage program budget, including staffing, operational costs, and member support resourcesAllocate resources efficiently across counties based on member needs and program prioritiesTrack and report on program expenditures and return on investmentExample: Create a resource allocation model that adjusts staffing levels based on member acuity and geographic considerations while maintaining cost-effectivenessProgram Innovation & GrowthIdentify opportunities to enhance program effectiveness through innovative approachesDevelop proposals for program expansion or new service offeringsStay current on industry best practices and integrate relevant approachesExample: Pilot a telehealth component to supplement in-person visits for rural members, evaluating impact on engagement and outcomes before regional implementationAdditional Examples Of ECM Program Manager RoleWeekly Meeting ManagementDesign an effective weekly team meeting structure that balances operational updates, case reviews, professional development, and team buildingRotate meeting facilitation responsibilities among Lead Care Managers to develop leadership skills across the teamImplement a "bright spots" segment in weekly team meetings where staff share success stories and effective intervention strategiesUse weekly team meetings as an opportunity to recognize staff achievements and celebrate program milestonesOne-on-One Meeting ManagementMaintain a structured agenda template for weekly one-on-ones that includes caseload review, performance metrics discussion, professional development check-in, and resource needs assessmentDocument key discussion points and action items from each one-on-one meeting, with follow-up tracking to ensure completionUse these meetings to identify systemic issues that may require program-wide solutions or policy adjustmentsDevelop individualized coaching approaches for each Lead Care Manager based on their learning style, experience level, and areas for growthTeam Leadership & DevelopmentImplement a structured mentorship program where you pair new Lead Care Managers with experienced ones across different counties to facilitate knowledge transfer and consistent practice standardsLead quarterly regional training sessions focused on complex case management strategies, addressing topics like managing members with co-occurring behavioral health and chronic medical conditionsCreate a cross-county peer learning community where Lead Care Managers can share best practices and problem-solve togetherOperational ManagementLead Monday morning operational huddles with all Lead Care Managers to review the week's priorities, address staffing challenges, and highlight critical member situations requiring attentionReview and analyze weekly performance dashboards showing county-by-county metrics on member engagement, visit completion, and outcome measuresConduct bi-weekly case conferences focused on complex members who require multi-disciplinary approaches or have challenging barriers to engagementStakeholder ManagementPrepare and present quarterly program performance reports to health plan leadership, demonstrating impact on utilization, quality measures, and member outcomesDevelop and maintain relationships with county behavioral health directors to improve coordination for members with mental health and substance use disordersCreate and distribute a monthly ECM program newsletter highlighting success stories, best practices, and upcoming initiatives for internal and external stakeholdersQualificationsEducation & ExperienceMaster's, or Bachelor's degree in Healthcare Administration, Public Health, Nursing, or related field5+ years of experience in healthcare management, with at least 3 years in care/case management servicesMinimum of 2 years of direct experience working in Enhanced Care Management programs or equivalent intensive care management initiativesDemonstrated understanding of ECM program requirements, populations of focus, and care management best practices specific to high-need Medicaid populationsPrevious supervisory experience managing teams across multiple locationsKnowledge & SkillsThorough understanding of care management principles and practicesStrong knowledge of healthcare delivery systems and Medicaid/Medicare programsIn-depth familiarity with California's ECM program structure, reporting requirements, and quality metricsExperience interpreting and implementing ECM policy guidance and requirements from the Department of Health Care ServicesExcellent analytical skills to evaluate program effectiveness and implement improvementsAdvanced proficiency in healthcare data analysis and quality improvement methodologiesPersonal AttributesExceptional leadership abilities with demonstrated success in team developmentStrong communication and interpersonal skillsAbility to manage multiple priorities in a fast-paced environmentCommitment to person-centered care and health equityWorking ConditionsPrimary office location in San Marcos with regular travel (30-40%) to county sites throughout Southern CaliforniaOccasional evening/weekend availability for special program initiatives or urgent situationsThis position offers an opportunity to make a significant impact on vulnerable populations through innovative care management approaches while leading a dedicated team of healthcare professionals across Southern pensation And BenefitsSalary Range: $80,000–$90,000 annuallyHours: Monday through Friday; some evenings and some weekends requiredBenefits: 401(k), health/dental/vision insurance, life insurance, paid time offAdditional: Mileage reimbursement at the IRS standard rateJob Type: Full-timePay: $80,000.00 - $90,000.00 per yearBenefits401(k)Dental insuranceHealth insuranceLife insurancePaid time offVision insuranceWork Location: On the roadSeniority levelSeniority levelMid-Senior levelEmployment typeEmployment typeFull-timeJob functionJob functionHealth Care ProviderIndustriesHospitals and Health CareReferrals increase your chances of interviewing at Pacific Health Group by 2xGet notified about new Care Manager jobs in San Diego, CA.Supervisor, Food Services (Casual) - KitchenCare Manager, Health Plan, Part Time, Licensed/Remote in CACare Manager, Health Plan - Licensed/Remote in CAHospice Director of Patient Care Services (RN)Behavioral Health Care Manager Remote, must be Licensed and Reside in California(RN) Care Manager - East Campus - 135896San Diego County, CA $23.00-$28.00 2 weeks agoWe’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr

Created: 2025-09-17