Pacific Health Group is hiring a Community Support Lead Care Manager to help Medi-Cal members live more independently by addressing their health-related social needs. In this remote role within California, you will be the personal guide for members, developing tailored care plans and coordinating all aspects of their care.
What You'll Do
- 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.
- 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.
- Ensure all records comply with legal, ethical, and organizational standards for quality and accountability.
- 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.
- Encourage peer learning and continuous growth within the care team.
- 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.
What We're Looking For
- 3–5 years in case management, social services, or healthcare.
- Familiarity with Medi-Cal, CalAIM, and Community Supports programs.
- Knowledge of healthcare systems, managed care operations, and local community resources.
- Strong communication, empathy, cultural competence, and teamwork.
- Proven time management and attention to detail.
- Competence in using case management software, EHR systems, and related tools.
Technical Stack
- Case management software
- EHR systems
Team & Environment
You will mentor and collaborate with case managers while working with program leadership and interdisciplinary teams. Our culture is inclusive, mission-driven, and compassionate, focused on equity, dignity, and empowerment. We are dynamic and people-focused, requiring flexibility, emotional intelligence, and proactive communication.
Work Mode
This is a remote position for candidates located within California.
Pacific Health Group is an equal opportunity employer.
