Enhanced Care Management Lead Care Manager - San Benito County at Pacific Health Group

, California, United States -

Full Time

Start Date

Immediate

Expiry Date

22 Jul, 26

Salary

32.0

Posted On

23 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case management, Care coordination, Social services, Community outreach, Patient advocacy, Documentation, Time management, Communication, Resource navigation, Conflict resolution, Crisis intervention, Healthcare systems knowledge, Data entry, Relationship building, Independent work

Industry

Public Health

Description

About Pacific Health Group At Pacific Health Group, we’re more than just a healthcare organization—we’re a catalyst for positive change in our communities. Our Enhanced Care Management (ECM) programs focus on addressing social determinants of health and providing community-based services that truly meet each individual’s needs. As a Lead Case Manager, you won’t just create care plans—you’ll personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way. Why This Role Matters - Holistic Impact and Compassionate Care You won’t just coordinate clinical visits. You’ll respond to real-life challenges such as housing, food insecurity, and mental health, ensuring that members’ needs are addressed comprehensively. By forming strong, personal connections through frequent in-person visits, you’ll become a pivotal support system—someone members can rely on for comfort, guidance, and advocacy. What This Role Looks Like (Day-to-Day Reality) This is a high-impact, field-based role supporting members in the community. Manage a caseload of approximately 60–70 members Conduct 3–5 in-person visits per day (homes, shelters, community settings) Spend 60–70% of your time in the field Travel locally within Santa Clara County (mileage reimbursed) Coordinate care across medical, behavioral health, and community services Document in real-time or by end of day using internal systems What You’ll Do Care Coordination & Case Management Develop and manage individualized care plans Coordinate appointments, services, and follow-ups across providers Support transitions of care (hospital discharge, referrals, etc.) Member Engagement & Advocacy Build trust through consistent, in-person engagement Advocate for timely access to care, services, and resources Support members navigating housing, food access, transportation, and behavioral health needs Community Outreach & Engagement Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives Build and maintain relationships with community-based organizations, shelters, and local resource partners Identify opportunities to expand community presence and improve member access to services Community Resource Navigation Connect members to local programs and services Build relationships with community-based organizations Identify gaps in resources and escalate when needed Documentation & Compliance Complete timely and accurate documentation Maintain compliance with Medi-Cal, CalAIM, and ECM program requirements Team Collaboration Partner with internal teams, providers, and community stakeholders Participate in case conferences and care coordination meetings How Success Is Measured Consistent member engagement and visit completion Timely and accurate documentation Effective care coordination and follow-through Ability to manage caseload independently Positive collaboration with internal and external partners Ability to effectively communicate with internal and external stakeholders Who Thrives in This Role This role is a strong fit for someone who: Is comfortable working independently in the field Can manage a high caseload independently with minimal supervision Is resourceful, proactive, and solution-oriented Thrives in fast-paced, community-based environments Is passionate about supporting underserved populations Cares about their community and its people Independently navigate new software and company issued equipment Schedule: Monday – Friday | 8:30 AM – 5:00 PM Compensation: $29.00 – $32.00 per hour (based on experience) FLSA: Non-Exempt Location: Hybrid - Field Based This includes locations such as: Hollister San Juan Bautista Tres Pinos Paicines Minimum Qualifications Residency: Must reside in listed County Experience: 3–5 years in case management, social services, or healthcare (preferred) Experience with: Medi-Cal, CalAIM, or Enhanced Care Management (preferred) Working experience of healthcare systems and community resources is a plus Excellent communication, organization, and time management skills Proficiency with documentation systems and technology Ability to effectively communicate both written and verbally Requirements: Valid California Driver’s License and active auto insurance meeting CA requirements Reliable personal vehicle for daily work use Successful completion of background check (including MVR) Must be able to travel up to 60-70% within the county to conduct in person visits Must successfully complete a Testlify skills assessment Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received Must have effective Time Management skills Must have internet speed of - 300+ mbps download and 25+mbps upload Must be proficient in technology, including documentation systems, case management platforms, and communication tools Compensation & Benefits $29.00 – $32.00/hour (based on experience) Monthly stipend + mileage reimbursement PTO + paid sick time 11 paid holidays (including birthday + floating holiday) 4 paid volunteer hours per month 90% employer-paid employee-only medical benefits FSA Short-term & long-term disability, AD&D Employee Assistance Program (EAP) 401(k) with company match Quarterly in-person team events

Responsibilities

Manage a caseload of 60-70 members by developing individualized care plans and coordinating medical, behavioral, and community services. Conduct frequent in-person field visits to provide advocacy, support, and resource navigation for underserved populations.