Lead Care Manager

Stockton – 2291 W March – Stockton, CA 95207

Position Summary:

The Lead Care Manager will receive, review, and process all incoming Member referrals from the Medi-Cal managed care plan. Working as part of the Member's multidisciplinary care team, the Lead Care Manager will coordinate all aspects of Enhanced Care Management services, including outreach, eligibility verification, service coordination, authorization requests, and member support to address clinical and non‑clinical needs of high‑need Members.

• Have a strong working knowledge of care coordination, housing services, supportive services, and community resources.
• Intake and assess incoming participants to determine eligibility and prioritize the highest‑risk and high‑need Members; submit authorization requests to the health plan.
• Conduct outreach activities throughout the Medi‑Cal managed care plan service area, including in‑person, telephonic, street outreach, and engagement.
• Conduct comprehensive assessments and develop individualized care management plans with the Member.
• Manage a caseload of participants, maintaining client files and tracking pertinent data.
• Provide service coordination between Members and other entities.
• Ensure no duplication of services.
• Identify clinical and non‑clinical resources for the Member.
• Ensure Members receive continuous and integrated care among all service providers.
• Make referrals and conduct follow‑ups with medical providers, community‑based and social services, including housing.
• Support Members in treatment by coordinating appointments, transportation, medication review/reconciliation, reminders, and accompaniment, if needed.
• Maintain open and consistent communication with the Member’s multidisciplinary team.
• Follow clients through and among services to achieve health stability.
• Provide daily, weekly, and monthly reports as requested.
• Perform heavy documentation using West Care’s Clinical Data System.
• Maintain regular contact with members to ensure no gaps in designed activities, swiftly addressing those gaps to continue progress toward health and function.
• Provide all services in linguistically and culturally appropriate manner, including interpreters for those with limited English proficiency.
• Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of West Care Foundation.
• Perform any other duties as assigned.

• Two (2) years of case management or direct outreach experience preferred.
• Excellent communication skills.
• Bilingual preferred.
• Excellent computer and documentation skills.
• Ability to multi‑task.
• Valid driver’s license.
• Maintain and execute confidential information.
• Demonstrated ability to work with communities.
• CPR certification, First Aid certification, and an annual tuberculosis test.

• Preferred:
  Two‑year degree in Addiction Counseling, Psychology, Social Work, Community and Human Services, Rehabilitation Counseling, or a related field.
• Required:
  
  High school diploma or equivalent.

• Work performed in a combination of office and outdoor settings.
• Travel required.

• Occasional lifting of more than 50 pounds.
• Transportation of clients in company vehicle.
• Occasional risk of intensive physical activity with client.
• Sitting, standing, walking, reaching performed in the normal course of the position.
• No exposure to blood, body fluids, or tissues, but exposure or potential exposure may be required; personal protective equipment will be readily available for Category II tasks.