Care Manager II - CalOptima

HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

Benefits and perks:
• HR360 offers a robust benefits package, including PTO, 15 paid holidays, commuter benefits, retirement plans, and more!
• Employees qualify for public loan forgiveness programs
• Training and professional development opportunities
• Work with mission driven, compassionate colleagues and make a difference every day in the work that you do.


This is a union eligible position.
JOB SUMMARY
HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible
and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic
barriers to healthcare and promote health equity for all. We offer a wide range of services, including
mental health care, residential and outpatient substance use treatment, and primary health services.
Additionally, we provide transitional support for individuals re-entering the community after involvement
in the criminal justice system. By integrating physical and behavioral health, we empower individuals to
overcome challenges by addressing social determinants of health, fostering resilience, and facilitating
recovery.

CalAIM, a Department of Health Care Services (DHCS) initiative, aims to improve Medi-Cal recipients'
quality of life and health outcomes through system reforms. It introduces Enhanced Care Management
(ECM), a statewide Medi-Cal Managed Care Plan (MCP), that offers a person-centered, community-based
highest care management tier within the Medi-Cal MCP Population Health Management continuum.
Participating members are assigned a Case Manager who will meet them wherever they are: on the street,
in a shelter, in their provider’s office, or at home to coordinate their health-related care and services,
ensuring a holistic approach to their well-being. In addition, ECM offers community-based services to
address health-related social needs to help members live healthier lives and avoid more costly levels of
care. Some examples include support to secure and maintain housing, access to medically tailored meals
for short-term recovery, and various other community-based services.

Care Manager II facilitates care by connecting clients with suitable services to meet their needs, including
physical and mental health, substance use issues, employment (both residential and outpatient), legal
concerns, housing, community resources, and aftercare. role involves working directly with members in
diverse settings such as their homes, homeless encampments, service provider locations, and other areas
requiring outreach, therefore, reliable transportation is required.

This is a primarily field-based role with the option to work remotely up to two (2) days per week after the
successful completion of the probationary period, based on program needs and supervisor approval.
Remote work flexibility is subject to change in accordance with the organization's policies.

KEY RESPONSIBILITIES
Enrollment and Engagement
• Identify eligible individuals from various locations for enrollment into CalOptima’s MCP.
• Use multiple strategies for engagement (in-person meetings, mail, email, texts, telephone,
community outreach).
Client Care Activities
• Organize client care activities according to CalOptima's Managed Care Plan (MCP).
• Share information with the client’s multi-disciplinary care team.
• Implement activities identified in the MCP.
• Provide support to engage clients in their treatment including medication review, appointment
scheduling, transportation coordination, and addressing barriers to engagement.
• Assist with intake by completing required assessments.
• Connect clients to benefits, healthcare services, employment, housing, and community resources.
• Monitor client’s progress toward achieving treatment plan goals and provide treatment plan
input.
Care Coordination
• Maintain regular contact with all providers involved in the client’s care team.
• Ensure continuous and integrated care among all service providers.
• Refer and follow up with primary care, mental health, substance use disorder treatment, and
necessary community-based services.
• Collaborate with clients and their families for community reintegration.
• Collaborate with outside agencies to obtain needed community resources (housing, sober livings,
substance abuse recovery agencies, medical facilities, employment/education agencies, DPSS,
DMV or other needed resources).
• Communicate collaboratively with all members of the behavioral health te