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Pacific Health Group

Integrated Medi-Cal care coordination provider

Enhanced Care Management Program Manager

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeCalifornia, USA

About the Job

Requirements

  • A bachelor's or master's degree in Healthcare Administration, Public Health, Nursing, or a related field.
  • At least 5 years of healthcare management experience, including at least 3 years in care or case management.
  • At least 2 years managing Enhanced Care Management or intensive care management programs.
  • Understanding of care management principles and healthcare delivery systems.
  • Experience with Medicaid or Medicare programs and Enhanced Care Management program requirements.
  • Strong analytical skills and experience in data-driven program evaluation.
  • Must reside within the hiring county.
  • Must have a valid California driver's license and active auto insurance meeting California requirements.
  • Must have a reliable personal vehicle for daily work use.
  • Must successfully complete a background check, including a motor vehicle record review.
  • Must be able to travel up to 60–70% within the county to conduct in-person visits.
  • Must successfully complete a Testlify skills assessment.
  • Must have a reliable working laptop for the first 21 days of employment until a company-issued laptop is received; a personal equipment stipend is provided.
  • Must have effective time management skills.
  • Must have internet speed of at least 300 Mbps download and 25 Mbps upload.
  • Must be proficient in technology, including documentation systems, case management platforms, and communication tools.
  • Must be willing to work occasional evenings and weekends as needed.

Responsibilities

  • Mentor and guide Lead Care Managers across multiple counties.
  • Conduct weekly one-on-ones to address challenges, review caseloads, and provide coaching.
  • Lead weekly team meetings to share updates, review cases, and encourage collaboration.
  • Meet in person with staff regularly to maintain a strong leadership presence.
  • Establish benchmarks and metrics to track program performance.
  • Implement quality assurance protocols and standardized workflows.
  • Monitor staff performance and use data to identify trends and improvement opportunities.
  • Ensure members receive in-person visits and high-quality care.
  • Monitor documentation and provide support for challenging cases.
  • Implement strategies to improve member engagement and satisfaction.
  • Serve as liaison between the Enhanced Care Management program and hospitals, providers, and community organizations.
  • Collaborate with data and compliance teams to track outcomes and maintain regulatory standards.
  • Strengthen partnerships to improve care transitions and reduce hospital readmissions.
  • Develop and manage program budgets, allocate resources efficiently, and track expenditures.
  • Adjust staffing and resources based on member needs and program priorities.
  • Identify opportunities to enhance program effectiveness.
  • Pilot initiatives such as telehealth to expand access to care.
  • Stay current on best practices and integrate improvements.
  • Lead operational huddles and bi-weekly case conferences.
  • Develop mentorship programs and regional trainings for staff.
  • Prepare quarterly performance reports and maintain stakeholder relationships.

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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