ECM Lead Care Manager

Under general direction, the ECM Lead Care Manager serves as the primary point of contact for Managed Care Plan (MCP) members and their support systems, coordinating care across clinical, behavioral health, and community-based services. The Lead Care Manager provides whole-person care management for members within the Birth Equity population of focus, including pregnant and postpartum individuals and families with infants up to 12 months old. This role emphasizes engagement, assessment, care planning, resource linkage, and collaboration with multidisciplinary care teams to address medical, behavioral, and social determinants of health. This is a full-time, field-based position that includes in-person, community-based, virtual, and telephonic engagement within the service area. Approximately up to 40% of local travel is required.

Responsibilities

Conduct and coordinate comprehensive multidisciplinary assessments across physical health, behavioral health, oral health, and social support needs; Develop, implement, and maintain individualized Care Plans/Action Plans; Serve as primary point of contact for members and designated caregivers; Ensure members are connected to a primary care provider and have an identified Authorized Representative and/or caregiver; Deliver services where the member lives, seeks care, or finds most accessible, including office-based, telehealth, or field-based services; Connect members to non-clinical social and health-related services, including transportation and interpreting services; Utilize Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles; Coordinate Transitional Care Planning with hospitals, emergency departments, and other institutional providers; Provide health promotion services; Complete all required documentation accurately and within established timeframes; Conduct outreach, engagement, and follow-up with MCP members; Complete required screenings and assessments (e.g., ACEs, PHQ-9, GAD-7); Identify barriers to care and integrate findings into care planning; Conduct community outreach to support ECM enrollment; Develop and maintain collaborative relationships with healthcare providers, social service agencies, and community organizations; Attend required staff, team, and interdisciplinary care team meetings, supervision, and trainings

Requirements

Bachelor's degree with two (2) years of relevant case management or care coordination experience; OR Associate of Arts degree with three (3) years of relevant experience; OR High School Diploma or equivalency with four (4) years of relevant experience; Minimum of two (2) years' experience working with pregnant individuals, children, and/or parents/caregivers; At least two (2) years' experience coordinating services across healthcare, behavioral health, and community systems; Computer skills including web browsing, e-mail, data entry, and word processing; Proficient in Zoom, Adobe Suite, and Microsoft Outlook, Word, Excel, Teams, and PowerPoint; Approximately up to 40% local travel required; Holding and maintaining current auto insurance, current California Driver's License and DMV clearance for staff driving on behalf of CCRC; Full-time schedule with ability to work non-traditional hours including early mornings, late evenings, and weekends; Background check required; Live Scan Clearance / DOJ Fingerprinting for positions working directly with the public in child/community care settings; Health Clearance for positions working directly with the public or with at-risk populations; Federal Debarment Checks for positions acting in a principal capacity to federal funds

Nice to have

Bachelor's in early childhood education, social work, public health education, psychology, or a related field; Two (2) years or more of experience working with pregnant parents and families with children under 12 months old; Two (2) years of experience working with Electronic Health Records (EHR), EXYM, and linkages to local community resources; Familiarity with trauma-informed care and the effects of domestic violence, child abuse, parental alcohol and/or substance abuse, and perinatal depression on child development, or willingness to be trained; Demonstrates lived experience and a commitment to serving the perinatal population; Prior experience as a Community Health Worker, Peer Support Specialist or similar role; Ability to converse, write, and translate in English and Spanish

Benefits

Competitive compensation package; Medical, Dental, Vision, and Voluntary Life Insurance; Basic Life Insurance and Long Term Disability paid by CCRC; Employer Contribution and Employer Match in the 403(b) Retirement Savings Plan with 100% vesting; Generous Time Off Policy including Vacation, Sick Time, Holidays, and Paid Winter Break; Opportunities for learning and professional development, including education reimbursement; Employee Assistance and Wellness Programs; 501(c)(3) designation, eligible for Public Service Loan Forgiveness