Care Manager I - ECM, SD

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 person-centered, community-based highest care management tier within the Medi-Cal MCP Population Health Management continuum. Participating members are assigned a Care 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 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.

The Care Manager I 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. This in-person and field-based 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.

KEY RESPONSIBILITIES Enrollment and Engagement

Identify eligible individuals from various locations for enrollment into ECM. Use multiple strategies for engagement (in-person meetings, mail, email, texts, telephone, community outreach).

Client Care Activities

Organize client care activities according to Managed Care Plan (MCP) requirements. 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.