SUMMARY
The Enhanced Care Management (ECM) program provides a whole-person approach to care that addresses the clinical and non-clinical circumstances of high-need members enrolled in Medi-Cal managed care. In this role, the applicant is expected to be flexible in fulfilling a variety of program roles for the day-to-day operations of CalAIM Enhanced Care Management program. The ECM Care Manager (RN/CM) will work with and provide support to upper management to ensure operations are running smoothly and production goals are met. They will also work with leadership, providers, and managed care plans to determine the needs of high acuity and vulnerable clients. This will include providing basic housing assistance, patient tailored intensive case-management, developing a care/service plan; provide linkages to medical, psychiatric, social, educational, and other services as needed. The RN/CM will work with the Community Supports Program staff to provide team-based, patient-centered care management for homeless and at-risk of homelessness clients. The goal of our ECM program is to effectively manage high utilizers and homeless patients during their continued care to ensure that their medical and psychosocial needs are met and to minimize the likelihood of preventable hospital admissions and emergency department utilization.
Inland Housing Solutions (IHS) is a community-based 501(c)(3) nonprofit organization with over 35 years of experience serving the homeless, at-risk, and those needing affordable housing. The mission of IHS is to break the cycle of homelessness in the Inland Empire, by providing permanent housing options and other essential services to individuals and families who have no place to live. IHS is an organization that strives for an integrated and comprehensive approach to helping individuals and families overcome their challenges or circumstances while being responsive to ever evolving industry best practices. This focus holistically creates a supportive environment for addressing community gaps for our most vulnerable individuals and families. The RN/CM holds a crucial role and responsibility to maintain and sustain efficient operations for everyday success in our ECM Program.
This position is ideal for someone passionate about Whole-Person Care and understands the impact of Social Drivers of Health (SDOH). Our focus on housing and stabilization goes beyond mere service delivery—it’s about creating environments where individuals and entire communities can thrive. We need a proactive leader, committed to developing and steering initiatives that have a lasting impact on the communities we serve. As an ideal candidate, you will be able to motivate, and empower talent. You will be personable, display excellent leadership skills, and exhibit proven experience in program leadership.
This position offers a competitive annual salary ranging from $80,000 to $120,000, depending on experience. It is a full-time, exempt role. While the initial six (6) months will require on-site attendance to support the launch of our new program, there may be potential for a hybrid work arrangement with three (3) days in the office and two (2) days remote, contingent upon the program's successful implementation and operational needs.
POSITION DESCRIPTION
Under the direction of ECM Program Manager, the RN/CM will manage and supervise all aspects of their given team and assist with client care and program needs. This position will provide lead coordination of care for their teams and clients. Clients with points of focus such as: multiple chronic medical & mental health conditions, homelessness, and substance abuse.
The RN/CM provides training, leadership, coordination, and paraprofessional support to assigned staff. RN/CM’s are also responsible for auditing and reviewing documentation to ensure compliance with managed care and ensure quality of care.
As ECM Care Manager (RN/CM), you will also promote, outreach, and enroll clients into Enhanced Care Management Program (ECM). You will carry a caseload of clients and will do this by determining the needs of high acuity, vulnerable clients and provide basic housing assistance, client tailored intensive case-management, developing a care/service plan; provide linkages to medical, psychiatric, social, educational, and other services as needed. RN/CM’s have the ability to literally meet the client where they are to conduct the needed case-management services. Work with medical/behavioral providers and clients to implement and perpetuate treatment and chronic disease self-management for clients enrolled in ECM. You will develop and maintain Care Management Plan’s and review the team for compliance; assist with crises within their teams, and their caseload; coordinate support services and reviews progress toward goals for clients; completes scales and assessments as appropriate, needed and as directed by Program Manager / Director of ECM.
MAJOR DUTIES AND RESPONSIBILITES
1. Supervises day-to-day operations and staff as assigned.
2. Provides support to the Program Manager, assisting with daily operations, managing staffing schedules, calendaring, and liaising with community partners, especially in regard to staffing.
3. Build positive staff relationships, inspires other to perform at a higher level, and retains an accountable workforce.
4. Meet and facilitate meetings with ECM teams to provide updates and develop strategies for program quality assurance and quality improvement.
5. In accordance with personnel policies and procedures, assists in the hiring and onboarding of new staff, managing employee relations and disciplinary actions.
6. Provides oversight of cases, reviews and audits case files, sits in on appointments, and provides prompt and actionable feedback to subordinates.
7. Provides and ensures all staff receive all new hire and annual trainings on time.
8. Conducts regular staff meetings, including communication and training of program policies and procedures, outcomes and evaluations, and compliance matters.
9. Assures staff participation in required training programs and compliance with safety rules, health practices, incident, and mandatory reporting requirements.
10. Interprets and explains program requirements and policies to staff, clients, and the community.
11. Conducts initial screening, assessments, and reassessments to determine the continued needs of the client.
12. Conducts outreach, enrollment, monthly reporting, and accurate completion of comprehensive risk assessments and care plans.
13. Conducts outreach, enrollment, monthly reporting, and accurate completion of comprehensive risk assessments and care plans.
14. Conducts proper intake steps such as patient data collection, eligibility, program enrollment, care plan development, and assessment of needs.
15. Works with leadership, providers, and managed care to develop and implement patient focused care plans for clients with chronic conditions.
16. Provides direct care management services to ECM participants in their assigned case load in line with ECM guidelines and recommended services.
17. Conducts regular reviews of patient’s chart to ensure quality services are provided and documented by Care Coordinators (CC) and Community Health Workers (CHW) consistently and accurately.
18. Responds to client inquiries and refer members to other departments, social services or support services as needed.
19. Works with the Housing Navigation team to ensure enrolled patients, who are experiencing homelessness or are at risk of homelessness, receive proper services.
20. Performs other related duties as assigned.
Required Skills/Abilities:
1. Knowledge and experience with Electronic Medical Records.
2. Knowledge of Medi-Cal state and federal laws, rules, and regulations.
3. Understanding of principles and practices of healthcare systems, including state Medi-Cal program and managed care organizations.
4. Experience in Excel, google sheets and docs.
5. Experience working with homeless, criminal justice, or other underserved populations.
6. Ability to communicate effectively in both written and verbal form to patients, public, medical staff, and physicians.
7. Strong problem-solving skills.
8. Excellent counseling skills and ability to relate to multi-ethnic community and varied income levels.
9. Strong interpersonal skills to establish productive working relationships with multidisciplinary team and support services.
10. Ability to work independently, collaboratively, and possess strong time management skills.
QUALIFICATIONS FOR THE JOB
Minimum Requirements:
· Bachelor’s Degree in a healthcare, behavioral healthcare, or related field and three or more years of experience in one or more of the following areas: utilization management, case management, care transition, and/or behavioral health.
· Minimum one year of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
· Experience working within applicable state, federal, and third-party regulations.
· Three years of experience in the health care, case management, or related field.
· Minimum of one year experience in Electronic Medical Records (EMR) like Epic or Care Director
Required License, Certification, Association:
· Registered Nurse: License must be active, unrestricted, and in good standing.
· CPR certified.
· Valid driver’s license with good driving record and be able to drive within applicable locality with reliable transportation.
Preferred:
· Master’s Degree in healthcare, behavioral healthcare and/or current RN or LCSW license.
· Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare management certification.
· Medicaid/Medicare Population experience with increasing responsibility.
BENEFITS
Inland Housing Solutions offer the following to full-time employees:
· Medical/Dental/Vision (80% Employee only paid by Employer, and 50% of employee dependents) and Life Insurance Plans.
· CalSavers (employee contribution only) Retirement Savings Plan or Simple IRA with a 3% match employer contribution.
· 13 paid Holidays per year.
· Vacation and Sick Paid Time Off.
PHYSICAL REQUIREMENTS
1. Must have the ability to walk properties, kneel, climb ladders, etc.
2. Must be able to sit for long periods of time.
3. Driving long periods of time throughout Riverside and San Bernardino County
4. Must have manual dexterity.
5. Normal range of hearing and vision
6. Regularly required to operate a computer keyboard, mouse, telephone, reach with hands and arms
7. Must be able to lift up to 25 lbs. at a time.
8. Must have the ability to communicate well with others.
9. Potential opportunity for a Hybrid position.
At IHS we are people advocates. We recognize that individuals come from all walks of life, have different circumstances, or may even have a disability. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering exceptional lifetime service to our members. We are committed to creating a workplace where all employees, regardless of background, or characteristics, are engaged, feel they belong, and can grow and develop long careers with our organization. We welcome you to apply!
Job Type: Full-time
Pay: $80,000.00 - $120,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Mileage reimbursement
- Paid sick time
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
License/Certification:
Ability to Commute:
- Loma Linda, CA 92354 (Required)
Ability to Relocate:
- Loma Linda, CA 92354: Relocate before starting work (Required)
Work Location: In person