Enhanced Care Management Program Manager at Adobe Care And Wellness LLC

, Arizona, United States -

Full Time

Start Date

Immediate

Expiry Date

18 Sep, 26

Salary

95000.0

Posted On

20 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case Management, Care Coordination, Population Health, Clinical Leadership, Staff Supervision, Performance Management, Regulatory Compliance, Interdisciplinary Team Leadership, Electronic Medical Records, Microsoft Office, Utilization Management, Strategic Planning

Industry

Hospitals and Health Care

Description

ABOUT ADOBE Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 with a mission of positively impacting the lives we touch. Headquartered in Phoenix, AZ, with satellite locations across multiple states, APH fosters a culture rooted in inclusivity, human kindness, and high-quality care. Recognized by Inc. 5000 as one of America’s Fastest-Growing Private Companies and honored for a fifth consecutive year as a “Best Place to Work” by the Phoenix Business Journal, APH continues to expand its reach and impact. APH partners with health plans, providers, hospitals, and families to deliver tailored programs including case management, in-home and in-clinic wellness assessments, preventative care, transitional care, and social services. As one of the nation’s few fully integrated healthcare organizations, APH delivers comprehensive, coordinated medical and social support through a wide range of specialized service lines. With continued growth on the horizon, APH is seeking mission-driven individuals who are passionate about improving health outcomes and supporting those in need. POSITION PURPOSE The ECM Program Manager is responsible for the operational and clinical oversight of Adobe Population Health’s Enhanced Care Management (ECM) program in the State of California. This role provides leadership, supervision, and direction to interdisciplinary care management teams to ensure high-quality, member-centered care coordination services that align with California Department of Health Care Services (DHCS), managed care plan requirements, NCQA standards, and organizational goals. The ECM Program Manager serves as a clinical leader and operational partner responsible for program implementation, quality outcomes, staff development, compliance oversight, and collaboration with health plans, providers, community-based organizations, and internal stakeholders. The individual in this role ensures the ECM program supports improved member outcomes, reduced utilization, enhanced member engagement, and resolution of social determinants of health barriers. This position requires a strong clinical background, leadership experience, and knowledge of Medi-Cal managed care, population health, care coordination, and California ECM requirements. DUTIES & RESPONSIBILITIES Clinical Oversight and Program Leadership * Provide clinical oversight and leadership for the ECM program and interdisciplinary care teams. * Ensure care management activities are compliant with DHCS ECM requirements, health plan contractual obligations, NCQA standards, and organizational policies. * Oversee development and implementation of individualized care plans for high-risk members with complex medical, behavioral health, and social needs. * Support care teams in identifying clinical priorities, barriers to care, and appropriate interventions to improve member outcomes. * Review and monitor clinical documentation for quality, accuracy, timeliness, and regulatory compliance. * Provide guidance and escalation support for complex clinical cases and high-risk member situations. * Ensure timely completion of assessments, outreach activities, care plans, transitions of care, and member follow-up activities. * Monitor ECM workflows and ensure program deliverables are consistently achieved. Operations and Performance Management * Manage daily ECM operations and assist with program growth and implementation initiatives. * Develop and monitor program metrics related to engagement, utilization, quality outcomes, and contractual performance requirements. * Analyze trends and identify opportunities for process improvement and operational efficiencies. * Participate in quality improvement initiatives and corrective action planning when necessary. Collaborate with internal leadership to support strategic initiatives, accreditation activities, audits, and reporting requirements. * Assist with development and maintenance of policies, procedures, workflows, and training materials. * Ensure appropriate staffing coverage and productivity standards are maintained. Staff Supervision and Development * Provide direct supervision, coaching, and performance management to ECM clinical staff and care coordination teams. * Conduct regular team meetings, case reviews, and clinical supervision sessions. * Assist with recruitment, onboarding, orientation, and ongoing staff development. * Foster a collaborative, accountable, and member-focused culture. * Promote employee engagement and professional development opportunities. Collaboration and Relationship Management * Serve as a liaison between Adobe Population Health, health plans, provider groups, hospitals, and community-based organizations. * Participate in interdisciplinary team meetings, utilization reviews, and case conferences. * Support collaborative relationships with community resources to address social determinants of health needs. * Represent the organization during client meetings, audits, and operational discussions as needed. Additional Responsibilities * Perform other duties as assigned to support organizational goals. SKILLS & QUALIFICATIONS * Minimum of five (5) years of clinical experience in case management, care coordination, population health, managed care, or related healthcare setting. * Minimum of three (3) years of leadership or management experience overseeing clinical teams. * Strong knowledge of California Medi-Cal managed care programs and Enhanced Care Management (ECM) model. * Knowledge of NCQA standards, utilization management principles, and population health strategies. * Experience working with high-risk and complex populations, including behavioral health and social determinants of health needs. * Strong understanding of interdisciplinary care coordination models. * Excellent verbal, written, organizational, and interpersonal communication skills. * Proficiency with electronic medical records, care management platforms, and Microsoft Office applications. * Experience with CalAIM initiatives is strongly preferred. * Experience working with health plans, delegated entities, or risk-bearing organizations preferred. * Bilingual skills preferred based on regional needs. EDUCATION, LICENSES, & CERTIFICATIONS * Bachelor of Science in Nursing (BSN) required. * Master’s degree preferred. * Active and unrestricted Registered Nurse (RN) license in the State of California. * Certified Case Manager (CCM) certification preferred. BENEFITS & TOTAL REWARDS * Paid Training and Onboarding * Insurance – Medical, Dental, Vision, and Life * 401k Plan – 3% match * Employee Assistance Program * Tuition Reimbursement * Continued Education Support * Mileage Reimbursement (if applicable) * Referral Bonuses * Paid Holidays (9 days) * Paid Time Off (20 days) * Paid Volunteer Hours CHARACTER & COMPETENCIES * Courage – To have the courage to the right thing at the right time. * Ownership – To take ownership of every issue you touch. * Respect – To respect yourself, co-workers, and for those whom you care. * Excellence – To be excellent in all that you do. * Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. * Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values. * Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. * Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. * Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. * Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. * Problem-Solving - Identifies and resolves problems promptly; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics. * Professionalism - Tactfully approaches others; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. * Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. PHYSICAL DEMANDS & WORK ENVIRONMENT * Occasionally required to stand. * Occasionally required to walk. * Continually required to sit. * Occasionally required to climb, balance, bend, stoop, kneel, or crawl. * Occasionally required to be exposed to warm or cool spaces. * Continually required to talk or hear. * While performing the duties of this job, the noise level in the work environment is usually moderate. * May occasionally lift and /or move more than 30 pounds. * Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing. EQUAL EMPLOYMENT OPPORTUNITY APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Responsibilities

Provide operational and clinical oversight for the Enhanced Care Management (ECM) program in California, leading interdisciplinary teams to ensure high-quality, member-centered care. The role involves managing program metrics, ensuring regulatory compliance with DHCS and NCQA standards, and collaborating with health plans and community providers.