Job Description

The Lead Care Manager provides comprehensive care coordination and support services to individuals with complex medical, behavioral health, and social needs. This role focuses on connecting members with healthcare and community resources, developing individualized care plans, conducting outreach, and promoting positive health outcomes through ongoing engagement. The position requires a combination of field-based visits, telephonic outreach, and collaboration with interdisciplinary care teams

Responsibilities/ Job Duties: 

• Conduct member outreach, screenings, and assessments to determine eligibility for care management services.
• Develop, implement, and regularly update individualized care plans based on member goals and identified needs.
• Provide ongoing care coordination through home visits, phone calls, telehealth, and community-based interactions.
• Coordinate services with healthcare providers, specialists, community organizations, and other members of the care team to ensure continuity of care.
• Assist members in navigating healthcare systems, scheduling appointments, and accessing appropriate medical, behavioral health, and social services.
• Connect members with community resources such as housing assistance, food programs, transportation, financial assistance, and other supportive services.
• Monitor member progress and conduct routine follow-up to ensure care plans and referrals are successfully completed.
• Identify safety concerns or barriers to care and follow appropriate protocols, including mandated reporting requirements when necessary.
• Maintain accurate, timely, and compliant documentation of all member interactions and care coordination activities within the electronic health record (EHR).
• Educate members on available resources, health management, and strategies to improve overall well-being.

Minimum Education and Experience Qualification Requirements: 

• High School Diploma or equivalent.
• Medical Assistant (MA) or Certified Nursing Assistant (CNA) certification or diploma preferred but not required 
• Experience working in medical field 
• Minimum of two (2) years of experience in healthcare, care coordination, case management, community health, or a related field.
• Valid driver's license, reliable transportation, and current auto insurance.

Preferred Qualifications:

• Bachelor's degree in Social Work, Psychology, Sociology, Public Health, or a related field.
• Experience supporting underserved or high-risk populations.
• Experience with care management, case management, Enhanced Care Management (ECM), or community-based health programs.
• Bilingual in English and Spanish.

Schedule/ Shift: Mon-Fri: 8:00am - 05:00pm

^*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).

^*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the 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.