Program Manager ECM

OverviewVista Community Clinic is a private, non-profit, multi-specialty outpatient clinic providing care in a comprehensive, high quality setting. Located in San Diego, Orange and Riverside counties, we work to advance community health and hope by providing access to premier health services. We are looking for dedicated, motivated, enthusiastic team players who want to make a difference in the community. Our competitive compensation and benefits program includes health, dental, vision, company-paid life, flexible spending accounts and a 403(B) plan, for eligible employees. VCC is an equal opportunity employer.ResponsibilitiesProvide direct oversight to the Enhanced Care Management program for select managed care plans and care managers including program development, implementation, supervision and training. Operate as part of the patients’ multi-disciplinary care team and responsible for interacting directly with the assigned health plan’s ECM Members and/or family, Authorized Representatives (ARs), caretakers and/or other authorized support person(s) as appropriate to coordinate all aspects of ECM and any Community Supports. Work with the ECM Clinical Nursing Specialist and other program staff to care coordinate designated populations of focus panel to ensure appropriate input is obtained to effectively coordinate all primary, behavioral, developmental, oral health, upports (LTSS), Community Supports and other services that address social determinants of health (SDOH).Essential Job Functions Supervisor ResponsibilitiesProvide supervision to assigned program staff and complete associated paperwork as required, including evaluations. Responsible for tracking and reviewing daily billing and coding reports to ensure monthly service expectations are met.Provide coaching to address performance improvement for direct reports.Monitor, assign, and track internal and external program referrals.Responsible for oversight of internal program reporting and identifying/addressing deficiencies in performance and quality of care.Participate in the development of workflows and assist the grant writing team, as neededAttend and facilitate internal staff and department meetings and external partner and/or collaboration meetings as required Identify and foster partnerships with community based organizations for program referrals Assist Program Manager in identifying outreach and enrollment strategiesMaintain knowledge of Health Plans platforms and documentationParticipate in Health Plans Audits and support development and implementation of corrective action plansUpdate workflows, training material, policies and procedures related to Care Manager roleAssist in training of Care Manager’s workflows and templatesPerform other duties as assignedCare Manager ResponsibilitiesMaintain a partial caseload of enrolled patients across all San Diego Health Plans, based on program need. Conduct outreach, enrollment and care management to selected population of focus determined by assigned health plan(s)Develop an individualized comprehensive management care plan integrating clinical and non-clinical needs to achieve health goals designed to improve functional status, health status, or prevent declineCoach patients and caregivers using evidence-based motivational interviewing techniques and trauma-informed care language to address critical issues to help patients develop achievable self-management care plan goals, presenting new skills using a step-by-step processAct as point of contact for patients and families involved in patients’ care team through any form of agreed-upon communicationSupport patients in the development of health care goals by conducting appropriate assessments that uncover comprehensive physical, mental, social and Community Supports’ needsVisit patients in their homes or where they seek care, or prefer to access services in their community using and completing patient interviews on health condition knowledge and motivation to engage in self-managementIdentify and initiate referrals for social service programs, such as financial, community and state supportive services alleviating housing instability and other social determinants of healthWork with ECM Clinical Nursing Specialist to monitor medication adherence to include medication management and reconciliation periodically for changes, especially at time of care transitionsPerform population management tasks such as appointment scheduling, prevention and screening recalls, monitoring referrals, patient portal callbacks and responding to telephone messagesEnsure proper, concise and accurate documentation of conversations held with patients and appropriate billing and coding are submittedProvide services in a culturally-appropriate and sensitive manner exhibiting the highest respect of all people and the strengths of their background, life experience and motivationsManage caseloads according to mandated program requirements to ensure compliance with timely completion of care planning, follow-up activities, documentation and submission timeframesServe as liaison between health plan(s), program and communityParticipate in health plan ECM-related auditsAttend mandatory in-service trainings and related meetings, providing feedback on the content of those attendedEnhance professional growth and development through participation in educational programs, current literature review, in-service meetings and workshopsSupport the vision, mission and goals, and demonstrate a commitment to the values, of the organizationCompile written reports as neededPerform other duties as directedQualificationsMinimumBachelor’s degree in social work, psychology, counseling, behavioral science, or other related fieldTwo years’ experience in a healthcare setting, preferably providing direct patient care, or with duties involving patient education and advocacy.Bilingual English/SpanishValid CA driver’s license and vehicle insurance, reliable transportationMinimum one year lead or supervisory experiencePreferredMaster’s degree in Social Work (MSW) or other related fieldExperience working with patients with a serious mental illness and/or substance use disorderRequired Skills/Knowledge/AbilitiesStrong interpersonal relationship, leadership, and communication skillsAbility and willingness to work flexible hours, including evenings and weekendsExcellent verbal and written skills necessary for communication with patients/clients, clinicians and other staffExcellent customer service skills and commitment to providing the highest level of customer satisfactionVisual acuity and hearing ability to drive safelyPay Range$27.00 -$29.00 hourlyPI274330624 Apply