ECM Lead Case Manager MSW -Santa Clara

We at Acacia believe in a patient first approach. You must be compassionate, caring, and work with your heart. We are more than just a team as we treat each other as family. If you are looking for a home health, palliative and hospice agency that treats patients & team members like family, then Acacia is for you.

The Case Manager will provide high quality case management to eligible Members with complex medical and social needs. In this vital role, the individual will perform outreach and engagement, conduct a comprehensive assessment with each Member, develop an individualized care plan, provide appropriate information and support regarding referrals and be the main support for Members throughout their participation in the program.

This is a hybrid position that requires traveling throughout the Santa Clara County area up to 5 days per week. Candidates wishing to be considered must reside within a 20 miles radius of the assigned territory due to frequency of travel.

• Assess Member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma informed care, social supports, housing, and referral and linkage to community based services and supports
• Oversees the development of the Member care plans and supports SMART goal setting
• Offer services where the Member resides, seeks care, or finds most easily accessible, including fieldbased services, office based, or telehealth
• Connect Member to other social services and supports that are needed
• Identify and eliminate clinical concerns
• Advocate on behalf of the Member with health care professionals (e.g. PCP, etc.)
• Utilize evidence based practices, such as Motivational Interviewing, Harm Reduction, and Trauma Informed Care principles
• Conduct outreach and engagement activities in order to facilitate linkage to the ECM program and log activity in the Care Navigation platform
• Complete all documentation, including outcome measures within the time frames established by the individual care plans
• Maintain uptodate Member health records in the Electronic Medical Record (EMR) system and other business systems
• Establishes and maintains effective working relationships with provider offices, County departments and other community agencies, and internal stakeholders related to care coordination for members, disease management, and health education
• Provide mentorship and coaching to other members of the team

• MSW Degree (Masters of Social Work)
• Willing and able to work Monday Friday 8:30am5:00pm, both in the field and remotely
• 4+ years experience as a case manager
• Working knowledge of government and community resources related to social determinants of health
• Excellent oral and written communication skills
• Positive interpersonal skills required
• Clean driving record, valid driver's license, and reliable transportation
• Must have general computer skills and a working knowledge of EMR / Care Management platforms

Position:
Full Time

Pay range: $34-38 per hour

Location:

Santa Clara/San Jose and surrounding cities

Remote, but MUST reside in Santa Clara County.