ECM Program Manager at Pacific Health Group

Key Responsibilities
Team Leadership & Supervision

• Directly supervise and mentor Lead Care Managers across multiple counties in Northern California
• Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals
• Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion
• Conduct regular performance evaluations and provide constructive feedback to optimize team performance
• Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress
• Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios
• Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations

Program Development & Quality Assurance

• Establish comprehensive benchmarks and performance metrics for the ECM program
• Design and implement quality assurance protocols to monitor service delivery and member outcomes
• Develop standardized workflows and procedures to ensure consistency across counties
• Example: Create a dashboard tracking key performance indicators such as member engagement rates, hospital readmission reductions, and health outcome improvements with monthly reporting to stakeholders
• Example: Review staff performance metrics during weekly one-on-ones, identifying trends and providing real-time guidance for improvement opportunities
• Example: Use weekly team meetings to review program-wide performance data and collaboratively develop improvement strategies

Member Services Oversight

• Ensure Lead Care Managers conduct regular in-person visits with ECM members
• Monitor frequency and quality of member interactions through documentation reviews and ride-alongs
• Implement strategies to improve member engagement and satisfaction
• Example: Institute a monthly audit process reviewing 10% of member files to verify appropriate in-person visit frequency, comprehensive assessment completion, and personalized care planning
• Example: Utilize weekly one-on-one meetings to review challenging member cases and collaboratively develop intervention strategies with Lead Care Managers
• Example: Dedicate time during weekly team meetings for case presentations of complex members, allowing for multi-perspective problem-solving and shared learning

Cross-Functional Collaboration

• Serve as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizations
• Collaborate with data analytics team to track program outcomes and identify improvement opportunities
• Partner with compliance department to ensure adherence to regulatory requirements
• Example: Establish quarterly collaborative meetings with hospital discharge planners to improve care transitions and reduce readmission rates for high-risk members
• Example: Provide updates during weekly team meetings on cross-departmental initiatives and partnership opportunities

Budget & Resource Management

• Develop and manage program budget, including staffing, operational costs, and member support resources
• Allocate resources efficiently across counties based on member needs and program priorities
• Track and report on program expenditures and return on investment
• Example: Create a resource allocation model that adjusts staffing levels based on member acuity and geographic considerations while maintaining cost-effectiveness

Program Innovation & Growth

• Identify opportunities to enhance program effectiveness through innovative approaches
• Develop proposals for program expansio