You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

The Lead Care Manager is responsible for assisting members and their families in obtaining and understanding services and programs available through the CalAIM program in order to improve their health and overall well-being.

Responsibilities / Job Duties

• Reviews data and interviews potential members to verify eligibility for enrollment in the program and completes referral process when necessary.
• Responsible for coordinating with individuals and/or entities to ensure a seamless experience for the member and non-duplication of services.
• Oversee provision of services, including the completion of the assessment, development of a Care Plan, providing educational information related to treatments, procedures, medications, and continuing care requirements in coordination with their healthcare providers to the assigned caseload.
• Work with healthcare professionals, community and social support services, and other company employees.
• Documents evidence of care in the member’s record in a concise and timely manner using the EHR system.
• Routinely checks in or schedules appointments with assigned members and maintains documentation of all member encounters to complete established reporting requirements.
• Whenever needed, accompany members to office visits to serve as an advocate.
• Communicates with providers and care team regarding the members' progress and care needs.
• Identifies and follows-up on all referrals made to assure continuity of care and that member/family needs are being met.
• Reassesses care plans to ensure effectiveness in achieving desired outcomes for members and their family.
• Addresses member questions and processes member requests in a timely manner.
• Investigates and directs member inquiries or complaints to appropriate staff members and follows up to ensure satisfactory resolution.
• Follows established policies to enroll and dis-enroll members.
• Maintains knowledge of community services and resources available to members including housing resources, financial/income assistance, transportation assistance, and food assistance.
• Follows established protocol around patients experiencing pain, safety concerns and/or mental health concerns and creates safety plans, if necessary.
• Recognizes signs of child and elder abuse and reports appropriately to Child/Adult Protective Services.
• Understands and abides by all departmental and company-wide policies and procedures.
• Complies with all safety and injury prevention policies and regulations.
• Performs other duties as assigned or required.

Minimum Education and Experience Qualification Requirements

Qualifications

• 2+ years of experience in any healthcare field.
• Fluent in English and Spanish (written and verbal) (preferred).

Experience

• 2+ years of experience in any healthcare field.

Skills

• Competent with computers, email, virtual platforms, Excel, and other Microsoft Office based programs.
• Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
• Ability to identify problems and use logic and related information to develop and implement solutions.
• Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.

Additional Requirements

• Current and valid Driver’s License and proof of auto insurance.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.