ECM Clinical Care Manager

Amity Foundation, an internationally acclaimed Teaching, and Therapeutic Community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as a ECM Clincal Care Manager. This groundbreaking opportunity will allow you to work with our prison and re-entry programs helping the community and will also enhance your training and experience in the field.   About Amity: Amity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed; responsibility developed, and lasting relationships built. Amity is dedicated to the inclusion and habilitation of people marginalized by addiction, homelessness, trauma, criminality, incarceration, poverty, racism, sexism, and violence. Amity is committed to research, development implementation, and dissemination of information regarding community building.   Remembrance, Resolution, Reconciliation, Restoration, Renewal

Job Summary:

The Enhanced Care Management (ECM) Clinician is responsible for member coordination, improving health outcomes, enhancing satisfaction, and reducing unnecessary healthcare utilization. ECM is a comprehensive, patient-centered approach to healthcare that aims to improve outcomes for high-need populations.  This involves the coordination of medical, behavioral, and social services to address the full range of member needs, focusing on those with complex and chronic conditions. 

ECM programs are designed to optimize care delivery, reduce unnecessary hospitalizations, and improve the overall quality of life for members. The intention of our services is to help people who have not been able to get the needed help in terms of Housing, Mental Health, Substance Abuse treatment, and linkages to community resources to help minimize recidivism.

The role of the ECM Clinical Case Manager provides integrated clinical and case management services to justice-involved individuals enrolled in Enhanced Care Management (ECM), with a primary focus on in-custody engagement within Orange County jail facilities and post-release community reintegration. This role delivers in-person assessments, pre-release planning, and clinical coordination inside the three Orange County jail facilities, while maintaining continuity of care through post-release case management, clinical touchpoints, and linkage to services in the community.

The Clinical Case Manager operates as part of a multidisciplinary Orange County care team, supporting individuals with complex medical, behavioral health, substance use, and social needs. The goal is to improve health outcomes, reduce recidivism, and support successful transitions to stable housing, treatment, and long-term community integration.

This position requires the ability to work effectively in secure custodial environments and field-based settings across Orange County, while adhering to all facility regulations and maintaining a high level of clinical and professional standards

 

Essential Duties:

 

• Interview and conduct clinical assessments of member’s needs, including medical, behavioral, and social factors.
• Develop, implement, and monitor personalized care plans in collaboration with members, their families, healthcare providers, and community resources.
• Conduct outreach to identify and engage eligible in ECM services, using multiple strategies and modalities for engagement.
• Operate as part of the member’s multi-disciplinary care team.
• Facilitate regular team meetings to review patient cases, address challenges, and share successes.
• Travel locally to deliver services to members in the community where they live, work, or frequent.
• Document services in the agency’s Electronic Health Record within 72 hours of each service and in compliance with agency policy, as well as contractual, state, and federal regulations.
• Provide accurate daily and monthly documentation and case notes as per funding source guidelines.
• Attend workshops, meetings, and trainings as requested by supervisor.
• Provide in-person pre-release case management services within Orange County jail facilities, including conducting assessments, initiating care plans, and engaging members before release.
• Complete and maintain clearance for county jail access, including passing all required background checks and complying with facility-specific rules and regulations at all times.
• Adhere to all county jail visiting policies, procedures, and security protocols, demonstrating professionalism and compliance in a custodial setting.
• Deliver comprehensive pre-release planning, including development of individualized care plans, coordination o