Lead Enhanced Care Manager

Description

This position serves as a lead-level resource for assigned programs by providing operational support, assisting with staff oversight, monitoring program performance, and ensuring high-quality Enhanced Care Management (ECM) services are delivered in accordance with organizational, contractual, and regulatory requirements

• Oversee and support the day-to-day operations of assigned programs, ensuring services are delivered effectively and in alignment with program goals, grant requirements, contractual obligations, and EPU standards.
• Assist with the supervision, training, coaching, and mentoring of assigned staff to promote quality service delivery and professional development.
• Serve as the primary point of contact for assigned programs and represent the department in the absence of the Manager or Director, as designated.
• Coordinate staffing and service delivery schedules to ensure continuity of services during staff absences, vacancies, and changing program needs.
• Monitor program operations and service quality to ensure compliance with organizational policies, funding requirements, and applicable regulations.
• Collect, track, analyze, summarize, and report program data, outcomes, and performance measures required by funding sources, organizational leadership, and program objectives.
• Ensure assigned staff conduct required home visits and maintain regular contact with families as outlined in care plans, program standards, and contractual requirements.
• Assist in identifying operational challenges and implementing solutions to improve program efficiency, effectiveness, and participant outcomes.

• Maintain and manage an assigned ECM caseload, as needed, ensuring timely and effective service delivery.
• Engage eligible members and coordinate services with individuals, providers, agencies, and community partners to ensure a seamless member experience and avoid duplication of services.
• Support the Supervisor in overseeing the delivery of ECM services and implementation of individualized care plans.
• Deliver services in locations most accessible and appropriate for members, including where they live, seek care, or otherwise receive services, in accordance with health plan requirements.
• Connect members to community resources, social services, transportation, and community supports that address identified needs.
• Advocate on behalf of members with healthcare providers and other service systems to improve access to care and resources.
• Coordinate with hospitals, healthcare providers, and community partners regarding discharge planning, treatment adherence, medication management, and continuity of care.
• Utilize motivational interviewing, trauma-informed care, and harm-reduction approaches when engaging with members and their support systems.
• Accompany members to appointments, when appropriate and permitted under health plan guidelines.
• Provide health education, health promotion, self-management support, and coaching to assist members in achieving their health and wellness goals.
• Maintain accurate, timely, and complete documentation, including case notes, assessments, care plans, and service activities in Apricot or other designated data systems in accordance with established protocols and regulatory requirements.
• Ability to follow detailed procedures, prioritize competing tasks, and complete documentation accurately and on time.
• Be familiar with EPU policies and procedures and maintain proper confidentiality.
• Maintain, manage, and process client records and information in a confidential manner that meets HIPAA and other applicable confidentiality regulations.
• The position requires the ability to meet with…