Pacific Health Group
Community Support Lead Care Manager – Remote
Pacific Health Group, California, Missouri, United States, 65018
Position Overview
At Pacific Health Group (PHG), we are at the forefront of revolutionizing health and wellness, setting new benchmarks in healthcare services through innovation, compassion, and community-driven care. Our mission is to empower members, uplift families, and positively impact the communities we serve.
Our Community Supports (CS) Program is designed to help Medi-Cal members live more independently in the community by addressing their health-related social needs. As a Community Supports Lead Case Manager, you won’t just create care plans; you’ll personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way.
Key Responsibilities
Member Outreach
Conduct comprehensive evaluations of members’ needs, preferences, and eligibility through detailed conversations and data review
Develop tailored care plans based on individual health and social circumstances
Arrange all aspects of member care, including scheduling appointments, organizing follow-up services, and linking members to community resources
Ensure members receive consistent, end-to-end support for long-term stability and health improvement
Perform empathetic assessments that capture members’ lived experiences and goals, not just medical data
Maintain close communication with members via phone, video, or in-person visits to monitor progress and address emerging challenges
Serve as a bridge between members and available community resources, such as housing programs, workforce training, childcare, and food assistance
Advocate for timely treatments, fair insurance authorizations, and equitable access to care
Act as the central communication hub among members, their families, healthcare providers, and community partners
Maintain accurate, up-to-date documentation of assessments, care plans, progress notes, and outcomes
Ensure all records comply with legal, ethical, and organizational standards for quality and accountability
Collect and analyze feedback to identify gaps in care coordination and advocate for new resources or partnerships
Remain current on Medi-Cal, CalAIM, and community support policies to ensure all activities meet compliance and quality-of-care standards
Participate in workshops, training, and certifications on cultural competence, trauma-informed care, and motivational interviewing
Encourage peer learning and continuous growth within the care team
Provide mentorship, guidance, and day-to-day support to other Care Managers within the Community Supports Program
Assist in onboarding new team members and promoting a collaborative, compassionate care environment
Support program initiatives and special projects as assigned
Demonstrate flexibility and teamwork to ensure departmental success.
Work Environment
Setting: Fully remote within California, with potential in-person visits or community engagement as needed
Schedule: Standard 8-hour shift, Monday through Friday, 8:30 AM – 5:00 PM
Culture: Inclusive, mission-driven, and compassionate, focused on equity, dignity, and empowerment
Pace: Dynamic and people-focused, requiring flexibility, emotional intelligence, and proactive communication
Key Internal Relationships
Care Management Team: Mentor and collaborate with case managers to coordinate care and maintain consistency in service delivery
Program Leadership: Work with management to align care strategies with organizational goals
Interdisciplinary Teams: Partner with social workers, behavioral health specialists, and outreach teams to support holistic member care
Key External Relationships
Members & Families: Build trusting relationships, ensuring members feel supported throughout their care journey
Community Organizations: Coordinate services for housing, employment, food security, and other essential needs
Healthcare Providers & Payers: Maintain communication for seamless coordination and access to care
Requirements
Experience: 3-5 years in case management, social services, or healthcare
Expertise: Familiarity with Medi-Cal, CalAIM, and Community Supports programs
Healthcare Insight: Knowledge of healthcare systems, managed care operations, and local community resources
Interpersonal Skills: Strong communication, empathy, cultural competence, and teamwork
Organizational Skills: Proven time management and attention to detail
Technical Proficiency: Competence in using case management software, EHR systems, and related tools
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Our Community Supports (CS) Program is designed to help Medi-Cal members live more independently in the community by addressing their health-related social needs. As a Community Supports Lead Case Manager, you won’t just create care plans; you’ll personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way.
Key Responsibilities
Member Outreach
Conduct comprehensive evaluations of members’ needs, preferences, and eligibility through detailed conversations and data review
Develop tailored care plans based on individual health and social circumstances
Arrange all aspects of member care, including scheduling appointments, organizing follow-up services, and linking members to community resources
Ensure members receive consistent, end-to-end support for long-term stability and health improvement
Perform empathetic assessments that capture members’ lived experiences and goals, not just medical data
Maintain close communication with members via phone, video, or in-person visits to monitor progress and address emerging challenges
Serve as a bridge between members and available community resources, such as housing programs, workforce training, childcare, and food assistance
Advocate for timely treatments, fair insurance authorizations, and equitable access to care
Act as the central communication hub among members, their families, healthcare providers, and community partners
Maintain accurate, up-to-date documentation of assessments, care plans, progress notes, and outcomes
Ensure all records comply with legal, ethical, and organizational standards for quality and accountability
Collect and analyze feedback to identify gaps in care coordination and advocate for new resources or partnerships
Remain current on Medi-Cal, CalAIM, and community support policies to ensure all activities meet compliance and quality-of-care standards
Participate in workshops, training, and certifications on cultural competence, trauma-informed care, and motivational interviewing
Encourage peer learning and continuous growth within the care team
Provide mentorship, guidance, and day-to-day support to other Care Managers within the Community Supports Program
Assist in onboarding new team members and promoting a collaborative, compassionate care environment
Support program initiatives and special projects as assigned
Demonstrate flexibility and teamwork to ensure departmental success.
Work Environment
Setting: Fully remote within California, with potential in-person visits or community engagement as needed
Schedule: Standard 8-hour shift, Monday through Friday, 8:30 AM – 5:00 PM
Culture: Inclusive, mission-driven, and compassionate, focused on equity, dignity, and empowerment
Pace: Dynamic and people-focused, requiring flexibility, emotional intelligence, and proactive communication
Key Internal Relationships
Care Management Team: Mentor and collaborate with case managers to coordinate care and maintain consistency in service delivery
Program Leadership: Work with management to align care strategies with organizational goals
Interdisciplinary Teams: Partner with social workers, behavioral health specialists, and outreach teams to support holistic member care
Key External Relationships
Members & Families: Build trusting relationships, ensuring members feel supported throughout their care journey
Community Organizations: Coordinate services for housing, employment, food security, and other essential needs
Healthcare Providers & Payers: Maintain communication for seamless coordination and access to care
Requirements
Experience: 3-5 years in case management, social services, or healthcare
Expertise: Familiarity with Medi-Cal, CalAIM, and Community Supports programs
Healthcare Insight: Knowledge of healthcare systems, managed care operations, and local community resources
Interpersonal Skills: Strong communication, empathy, cultural competence, and teamwork
Organizational Skills: Proven time management and attention to detail
Technical Proficiency: Competence in using case management software, EHR systems, and related tools
#J-18808-Ljbffr