P

Pacific Health Group

Integrated Medi-Cal care coordination provider

Enhanced Care Management Lead Care Coordinator

Full-Time
$29 - $32/hr+ Monthly stipend + Mileage reimbursement
Mid
California, USA
HybridMust reside in the hiring county; field visits require travel up to 60–70% within the county.
Social & Community ServicesCase Management & Advocacy

About the job

Requirements
  • Must reside in the hiring county.
  • Have 3–5 years of experience in case management, social services, or healthcare; this experience is described as preferred.
  • Have working experience with healthcare systems and community resources; this is described as a plus.
  • Have strong communication, organization, and time-management skills.
  • Be proficient with documentation systems, technology, case-management platforms, and communication tools.
  • Effectively communicate both in writing and verbally.
  • Hold 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 300+ Mbps download and 25+ Mbps upload.
  • Have effective time-management skills.
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 discharge and referrals.
  • Build trust with members through consistent, in-person engagement.
  • Advocate for timely access to care, services, and resources.
  • Support members navigating housing, food access, transportation, and behavioral health needs.
  • Represent Pacific Health Group 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 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 is preferred.
  • Working experience with healthcare systems and community resources is a plus.

About the company

Pacific Health Group delivers integrated Medi-Cal care coordination in California, working with 39 health plans to serve over 38,000 members in 44 counties. Its flagship Enhanced Care Management coordinates medical, behavioral, and social services for people with the most complex health needs, supplemented 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 for adults with mental illness. Guided by CalAIM, the organization aims to reduce fragmentation by addressing social determinants of health and managing risk and needs through a unified, whole-person approach.

Company Size

51-200

Company Stage

N/A

Total Funding

N/A

Headquarters

Carlsbad, California

Founded

2023

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Simplify Jobs

Simplify's Take

What believers are saying

  • Pacific launched 2026 Transitional Rent, unlocking mandatory managed-care demand immediately.
  • August 2026 messaging shows underused Northern California services, leaving substantial growth headroom.
  • 39 health-plan partners expand cross-sell opportunities across Medi-Cal counties and member segments.

What critics are saying

  • CalAIM rule changes from DHCS in 2026 can slash reimbursement and utilization fast.
  • Health Net, L.A. Care, and Partnership can insource care coordination, squeezing Pacific’s contracts.
  • A data breach or billing dispute would devastate trust because members receive no-cost sensitive services.

What makes Pacific Health Group unique

  • Pacific Health Group’s ECM, Community Supports, and Street Medicine bundle spans 39 health plans.
  • Its 2026 Transitional Rent offering fits California’s first mandatory Community Support statewide.
  • The company reports serving 38,000 members across 44 counties, giving statewide operational breadth.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Flexible Work Hours

Remote Work Options

Paid Vacation

Paid Sick Leave

Paid Holidays

Hybrid Work Options

401(k) Retirement Plan

401(k) Company Match

Employee Assistance Program

Professional Development Budget

Employee Discounts

Growth & Insights

Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%