Lead Care Manager
Serene Health, Modesto, CA, United States
Job Summary
The official job title is Lead Care Manager (LCM). The role involves developing personalized care plans, coordinating member services, and collaborating closely with members, families, and Primary Care Providers to ensure they receive necessary medical treatment and support. The LCM consults with members to determine their needs, develops individualized action plans, and works with care teams to manage the member experience effectively. Key responsibilities include providing emotional support, resolving administrative issues, and ensuring timely access to care. Compassion, healthcare knowledge, and exceptional customer service are essential qualities for assisting members in becoming self‑sufficient in health.
Responsibilities
Interview members to assess medical and social determinant of healthcare gaps, provide education about their condition and medication, and develop individualized care plans.
Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.
Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
Maintain ongoing contact with members via telehealth and in‑person visitation.
Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.
Maintain empathy and professionalism while contacting members and families.
Support behavioral health coordination, substance abuse and community resources.
Perform additional duties as assigned.
Populations of Focus
Individuals experiencing homelessness: lacking a fixed, regular, and adequate nighttime residence.
Individuals at risk for avoidable hospital or emergency department utilization: five or more ER visits in a six‑month period that could have been avoided with appropriate outpatient care or improved treatment adherence.
Individuals with serious mental health and/or substance use disorder needs: adults who meet eligibility criteria for specialist mental health services or the Drug Medi‑Cal system.
Individuals transitioning from incarceration/justice involvement: adults transitioning from a correctional setting within the past 12 months, or children/youth transitioning from a youth correctional facility within the past 12 months.
Adults living in the community at risk for long‑term care institutionalization: adults who meet the SNF level of care criteria or require lower‑acuity skilled nursing or equipment for prevention, diagnosis, or treatment of acute illness or injury.
Adult nursing facility residents transitioning to the community: residents likely candidates to move out successfully and able to reside continuously in the community.
Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with additional needs beyond the CCS condition: experiencing at least one complex social factor influencing their health.
Children and youth involved in child welfare.
Individuals with intellectual/developmental disabilities: adults diagnosed with I/DD who qualify for any other adult ECM population of focus.
Pregnant and postpartum individuals; birth equity population of focus: adults and youth pregnant or postpartum who qualify for eligibility in any other adult or youth ECM POF, or are subject to racial and ethnic disparities.
Education and Experience
High school diploma or GED required.
Minimum of 1 year experience in case management, member care, customer service, call center, or member care required.
Valid California driver’s license and valid vehicle insurance required.
MA certificate or medical terminology knowledge preferred.
Required Skills and Abilities
Excellent communication, interpersonal, customer service and organizational skills.
Computer skills for documentation, email and chat support.
Proficiency in working independently and collaboratively in a team to provide member care.
Proficiency in multitasking, organization, and attention to detail for effectively providing care to multiple members simultaneously.
Capability to utilize resources effectively for problem‑solving while maintaining composure under pressure in a compassionate manner.
Proficient speaking, reading, and typing abilities and strong proofreading skills.
Physical Requirements
Must be able to travel using personal vehicle to complete outreach visits; mileage reimbursement at standard rate.
Must successfully complete and maintain current tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.
Prolonged periods of sitting at an office desk on the computer.
Lifting: Able to lift up to 15 lbs.
Travel Details
First week of employment will report to the San Ramon office.
Mileage reimbursement is compensated at the IRS standard rate.
Commute to the San Ramon office is considered work time; staff member can leave home at the start of their scheduled shift.
First month: weekly visits on Wednesdays to the San Ramon office.
After the first month: evaluated on the frequencies of office visits; office visits will decrease to once per month based on office needs.
Pay and Benefits
Pay range: $25 USD – $28 USD per hour.
Benefits
Medical, Dental, and Vision Benefits: various insurance options for you and your family.
Short and Long‑Term Disability Benefits: protection when you need it most.
Voluntary Accident, Critical Illness, and Hospital Indemnity Plans: added security for you and your loved ones.
Flexible Spending Accounts.
Employee Assistance Program (EAP).
401(K) – effective after 1 year of employment.
Paid Vacation and Sick Leave.
Paid Holidays.
Employee Referral Program.
Company Discount Program.
Equal Employment Opportunity
Optima Medical Management Group and its divisions are an Equal Opportunity Employer. We are committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state, or local laws. We are committed to providing reasonable accommodation for individuals with disabilities.
Pre‑Employment
We are a drug‑free workplace. Employment is contingent upon a successful pre‑employment drug screening and background check.
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The official job title is Lead Care Manager (LCM). The role involves developing personalized care plans, coordinating member services, and collaborating closely with members, families, and Primary Care Providers to ensure they receive necessary medical treatment and support. The LCM consults with members to determine their needs, develops individualized action plans, and works with care teams to manage the member experience effectively. Key responsibilities include providing emotional support, resolving administrative issues, and ensuring timely access to care. Compassion, healthcare knowledge, and exceptional customer service are essential qualities for assisting members in becoming self‑sufficient in health.
Responsibilities
Interview members to assess medical and social determinant of healthcare gaps, provide education about their condition and medication, and develop individualized care plans.
Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.
Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
Maintain ongoing contact with members via telehealth and in‑person visitation.
Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.
Maintain empathy and professionalism while contacting members and families.
Support behavioral health coordination, substance abuse and community resources.
Perform additional duties as assigned.
Populations of Focus
Individuals experiencing homelessness: lacking a fixed, regular, and adequate nighttime residence.
Individuals at risk for avoidable hospital or emergency department utilization: five or more ER visits in a six‑month period that could have been avoided with appropriate outpatient care or improved treatment adherence.
Individuals with serious mental health and/or substance use disorder needs: adults who meet eligibility criteria for specialist mental health services or the Drug Medi‑Cal system.
Individuals transitioning from incarceration/justice involvement: adults transitioning from a correctional setting within the past 12 months, or children/youth transitioning from a youth correctional facility within the past 12 months.
Adults living in the community at risk for long‑term care institutionalization: adults who meet the SNF level of care criteria or require lower‑acuity skilled nursing or equipment for prevention, diagnosis, or treatment of acute illness or injury.
Adult nursing facility residents transitioning to the community: residents likely candidates to move out successfully and able to reside continuously in the community.
Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with additional needs beyond the CCS condition: experiencing at least one complex social factor influencing their health.
Children and youth involved in child welfare.
Individuals with intellectual/developmental disabilities: adults diagnosed with I/DD who qualify for any other adult ECM population of focus.
Pregnant and postpartum individuals; birth equity population of focus: adults and youth pregnant or postpartum who qualify for eligibility in any other adult or youth ECM POF, or are subject to racial and ethnic disparities.
Education and Experience
High school diploma or GED required.
Minimum of 1 year experience in case management, member care, customer service, call center, or member care required.
Valid California driver’s license and valid vehicle insurance required.
MA certificate or medical terminology knowledge preferred.
Required Skills and Abilities
Excellent communication, interpersonal, customer service and organizational skills.
Computer skills for documentation, email and chat support.
Proficiency in working independently and collaboratively in a team to provide member care.
Proficiency in multitasking, organization, and attention to detail for effectively providing care to multiple members simultaneously.
Capability to utilize resources effectively for problem‑solving while maintaining composure under pressure in a compassionate manner.
Proficient speaking, reading, and typing abilities and strong proofreading skills.
Physical Requirements
Must be able to travel using personal vehicle to complete outreach visits; mileage reimbursement at standard rate.
Must successfully complete and maintain current tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.
Prolonged periods of sitting at an office desk on the computer.
Lifting: Able to lift up to 15 lbs.
Travel Details
First week of employment will report to the San Ramon office.
Mileage reimbursement is compensated at the IRS standard rate.
Commute to the San Ramon office is considered work time; staff member can leave home at the start of their scheduled shift.
First month: weekly visits on Wednesdays to the San Ramon office.
After the first month: evaluated on the frequencies of office visits; office visits will decrease to once per month based on office needs.
Pay and Benefits
Pay range: $25 USD – $28 USD per hour.
Benefits
Medical, Dental, and Vision Benefits: various insurance options for you and your family.
Short and Long‑Term Disability Benefits: protection when you need it most.
Voluntary Accident, Critical Illness, and Hospital Indemnity Plans: added security for you and your loved ones.
Flexible Spending Accounts.
Employee Assistance Program (EAP).
401(K) – effective after 1 year of employment.
Paid Vacation and Sick Leave.
Paid Holidays.
Employee Referral Program.
Company Discount Program.
Equal Employment Opportunity
Optima Medical Management Group and its divisions are an Equal Opportunity Employer. We are committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state, or local laws. We are committed to providing reasonable accommodation for individuals with disabilities.
Pre‑Employment
We are a drug‑free workplace. Employment is contingent upon a successful pre‑employment drug screening and background check.
#J-18808-Ljbffr