Community Support - Lead Care Manager

Job DetailsJob Location: Hybrid, CA 95206-1234Position Type: Full TimeSalary Range: $30.00 - $35.00 HourlyJob Shift: DayJob Category: Admin - ClericalLead Care Manager, Community Supports Program at Pacific Health Group

Join Our Mission to Transform Lives: Community Supports

At Pacific Health Group, we’re more than just a healthcare organization—we’re a catalyst for positive change in our communities. Our Community Supports (CS) Program is designed to help Medi-Cal members live more independently in the community by addressing their health-related social needs. As a Community Supports Lead Case Manager, you won’t just create care plans—you’ll personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way.

Why This Role Matters - Holistic Impact and Compassionate Care

You won’t just coordinate phone calls. You’ll respond to real-life challenges such as housing, food insecurity, and mental health, ensuring that members’ needs are addressed comprehensively.
By forming strong, personal connections through you’ll become a pivotal support system—someone members can rely on for comfort, guidance, and advocacy.

Advocacy and Going the Extra Mile

Beyond paperwork and phone calls, you’ll arrange all necessary services to secure safe housing and financial support.
You’ll be a consistent presence in members’ lives, making sure no detail goes overlooked and no obstacle remains unaddressed.

Shaping the Future of Care

Your hands-on experience will generate insights that directly influence how our CS program evolves, ensuring we remain responsive to community needs.
By sharing feedback on what members truly need, you’ll help refine the processes and resources we use to serve diverse populations.

Your Responsibilities

Comprehensive Care Coordination
End-to-End Service Arrangement: Schedule appointments, organize follow-up care, link members to social services, and ensure they have the resources for a full continuum of support.
Case Management with a Heart
Empathetic Assessments: Look beyond forms and checkboxes to truly understand members’ backgrounds, personal challenges, and aspirations.
Continuous Support: Remain in close contact by phone, video, and in-person visits to monitor progress, celebrate milestones, and swiftly address any new barriers.
Example: If a member feels overwhelmed by multiple therapies, you could simplify their schedule, coordinate telehealth sessions, and even offer emotional support through regular check-ins.
Resource Management
Bridge to Community Services: Identify, coordinate, and optimize local resources—such as housing assistance, job training programs to ensure members’ overall wellbeing.
Example: A single parent needing childcare and employment support could be connected to subsidized daycare, workforce development courses, and a community mentor program—all organized by you.
Patient Advocacy
Champion for Members’ Rights: Push for timely treatments, insurance authorizations, and fair access to services, resolving roadblocks that could hinder progress.
Example: If a critical procedure is denied by insurance, you’ll take charge of the appeals process, gathering documents and evidence to secure approval.
Communication
Central Point of Contact: Keep members, families, healthcare teams, and community organizations aligned on care objectives, ensuring seamless handoffs and follow-through.
Example: Coordinate a care conference among a primary care physician, social worker, and rehab specialist so everyone can align on the most effective plan for a member’s speedy recovery.
Documentation
Detailed Reporting: Maintain meticulous records of assessments, care plans, and progress notes, ensuring transparency and accountability at every stage.
Example: After every phone call document any social, environmental, or health updates, enabling prompt collaboration with other team members and service providers.
Continuous Improvement
Feedback and Adaptation: Use data and first-hand observations to refine care strategies, ensuring our CS program stays effective and deeply compassionate.
Example: If you notice a high number of members struggling with job access, you might advocate for creating a new partnership with a local job placement agency.
Regulatory Compliance
Stay Current: Keep informed about Medi-Cal, CalAIM, and other regulations, ensuring that all care management practices meet legal and quality-of-care standards.
Example: Complete continuing education on the latest CalAIM guidelines and integrate these protocols into your daily workflow.
Professional Development
Ongoing Learning: Attend training, workshops, and webinars to sharpen your skills in cultural competence, motivational interviewing, and crisis intervention.
Example: Enroll in a course on trauma-informed care to better support members who have experienced past hardships.
Other Duties
Collaborative Mindset: Rem