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Pacific Health Group

Integrated Medi-Cal care coordination provider

Enhanced Care Management Lead Care Coordinator

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeCalifornia, USA

About the Job

Requirements

  • Must reside in the hiring county.
  • Have 3–5 years of experience in case management, social services, or healthcare; the posting marks this experience as preferred.
  • Have experience with Medi-Cal, CalAIM, or Enhanced Care Management; the posting marks this experience as preferred.
  • Have working experience with healthcare systems and community resources; this is described as a plus.
  • Have effective written and verbal communication skills.
  • Have organization and time management skills.
  • Be proficient with documentation systems, technology, case management platforms, and communication tools.
  • Have a valid California driver’s license and active auto insurance meeting California requirements.
  • Have a reliable personal vehicle for daily work use.
  • Successfully complete a background check, including a motor vehicle record check.
  • Be able to travel up to 60–70% within the county to conduct in-person visits.
  • Successfully complete a Testlify skills assessment.
  • Have a reliable working laptop for the first 21 days of employment until the company-issued laptop is received.
  • Have internet speed of at least 300 Mbps download and 25 Mbps upload.

Responsibilities

  • Manage a caseload of approximately 60–70 members.
  • Conduct 3–5 in-person visits per day in homes, shelters, and community settings.
  • Spend 60–70% of work time in the field and travel locally within the hiring county; mileage is reimbursed.
  • Coordinate care across medical, behavioral health, and community services.
  • Document in real time or by the end of the day using internal systems.
  • Develop and manage individualized care plans.
  • Coordinate appointments, services, and follow-ups across providers.
  • Support transitions of care, including hospital discharges and referrals.
  • Build trust through consistent, in-person engagement with members.
  • Advocate for timely access to care, services, and resources.
  • Support members navigating housing, food access, transportation, and behavioral health needs.
  • Represent the organization in the community through outreach events, partnerships, and local initiatives.
  • Build and maintain relationships with community-based organizations, shelters, and local resource partners.
  • Identify opportunities to expand community presence and improve member access to services.
  • Connect members to local programs and services.
  • Identify gaps in community resources and escalate them when needed.
  • Complete timely and accurate documentation.
  • Maintain compliance with Medi-Cal, CalAIM, and Enhanced Care Management program requirements.
  • Partner with internal teams, providers, and community stakeholders.
  • Participate in case conferences and care coordination meetings.

Desired Qualifications

  • Experience with Medi-Cal, CalAIM, or Enhanced Care Management.
  • Working experience with healthcare systems and community resources.

About the Company

Pacific Health Group

Integrated Medi-Cal care coordination provider

Pacific Health Group provides integrated Medi-Cal care coordination in California, working with 39 health plans to serve more than 38,000 members across 44 counties. Its flagship Enhanced Care Management coordinates medical, behavioral, and social services for members with complex needs, complemented by Community Supports like housing navigation, rent assistance, medically tailored meals, and home modifications. Street Medicine reaches unsheltered individuals, while Community Health Workers provide culturally responsive care navigation and advocacy; additional services include behavioral health support, medical transportation, and a Clubhouse program for adults with mental illness. The approach follows CalAIM’s whole-person care, addressing social determinants of health to reduce fragmentation and improve stability for at-risk Medi-Cal beneficiaries.

Company size
51-200
Company stage
Not listed
Total funding
Not listed
Headquarters
Carlsbad, CA
Founded
2023

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