CalAIM Lead Care Manager

Position Summary:

New Beginnings is seeking a qualified and experienced Lead Care Manager to provide comprehensive oversight and support for the Enhanced Care Management (ECM) and Community Supports (CS) programs under our CalAIM initiative. The Lead Care Manager will be responsible for ensuring that all ECM and CS activities are effectively managed, including utilization management, member assignment, reporting, and staff supervision. This role requires a deep understanding of Medi-Cal and CalAIM processes, and the ability to optimize service delivery while ensuring compliance with all relevant regulations and standards.

Key Responsibilities:

• Program Oversight: Provide leadership and oversight for all ECM activities, including utilization management, member assignment, and reporting. Ensure that all program deliverables are met and that ECM and Community Supports services are delivered effectively and efficiently.
• Staff Management: Supervise and manage a team of two direct billing and authorization staff members, overseeing their productivity, compliance, and professional development. Monitor staff performance and provide ongoing support to ensure high-quality service delivery.
• Regulatory Compliance: Stay current with state and federal regulations related to CalAIM, Medi-Cal, and ECM/CS. Ensure that all activities and documentation meet regulatory requirements and that the program remains in full compliance.
• Care Management: Track and ensure the timely completion of ECM assessments and care plans. Oversee the documentation of Community Supports services, ensuring that all records are accurate and complete. Conduct assessments with clients as necessary in the field at times when program staff are at capacity.
• Provider Oversight: Provide oversight of ECM and Community Supports service provision by program staff in conjunction with Program Directors, ensuring that core services are delivered as required. Work closely with providers and Program Directors to optimize service delivery and address any issues or concerns that arise.
• Process Optimization: Optimize internal and external CalAIM processes, making recommendations for improvements to enhance service delivery and program efficiency.
• Documentation and Reporting: Review case notes and related documentation in the Health Management Information System (HMIS). Track authorizations and assist with claims reviews as necessary to ensure accurate and timely billing.
• Quality Improvement: Participate in internal and external meetings as necessary. Provide suggestions for quality improvement initiatives to enhance the effectiveness of ECM and Community Supports programs.
• Additional Duties: Perform other duties as assigned by the Program Director, Homeless Services Director and Executive Director to support the successful implementation and operation of the CalAIM initiative.

Qualifications:

• Education and Licensure:
  • Preferred: Associate or Licensed Mental Health Professional (e.g., LCSW, LMFT, LPCC), LVN, RN
  • Bachelor’s degree in social work, psychology, counseling, nursing, or a related field. Master’s degree preferred.
• Experience:
  • Minimum of 3-5 years of experience working with Medi-Cal members, particularly in care management or mental health services.
  • Experience in supervising staff and managing care coordination tasks.
  • Proven track record in implementing CalAIM or similar healthcare programs preferred.
  • Familiarity with utilization management, provider oversight, and billing processes in a healthcare setting.
• Skills and Competencies:
  • Strong leadership and staff management skills.
  • In-depth knowledge of Medi-Cal, CalAIM, and the needs of the Medi-Cal member population.
  • Excellent organizational and time-management skills.
  • Ability to analyze complex data, review documentation, and track program performance.
  • Strong communication skills, both written and verbal, with the ability to work collaboratively with a variety of stakeholders.
  • Proficiency in HMIS and other care management software preferred but not required.
  • Familiar with client intake and assessments
  • Ability to work unsupervised, in the field for part of shift with a commitment to issues related to ending homelessness through employment
  • Ability to set priorities, meet deadlines and follow through
  • Excellent written and oral communication skills
  • Strong organizational and time management skills.
  • High level of accuracy and attention to detail.
  • Ability to multitask and prioritize.
  • Excellent administrative skills.
  • Strong computer skills and knowledge of database and relevant software programs.
  • Ability to maintain professional conduct, attitude and appearance at all times
  • Proficiency in PC computer systems and Microsoft Office, including the ability to perform word processing, data entry, and other tasks at a computer workstation
  • Adhere to laws regarding confidentiality and reporting requirements; maintain knowledge of current HIPAA certification standards
  • Willingness to travel: Driver’s License:  A valid driver’s license and an operating insured, registered vehicle is required at the time of application. A valid California Class C Driver’s License is required at the time of appointment.

Work Environment:

This is a full-time, on-site position located at New Beginnings’ main office on Santa Barbara, with travel up to Mid and North County offices as needed. The Lead Care Manager will work closely with the Program Director, ECM and Community Supports providers, our data analyst, individual Program Directors, and various internal departments to ensure the successful implementation of CalAIM initiatives.

Work hours are Monday – Friday, 9-6 although there may be occasional night time and weekend hours to attend community events or attend to emergent client and administrative needs. Starting salary is $70,000 – $80,000 DOE with medical and dental benefits provided, 403b contribution and matching, as well as generous paid time off. Position begins asap.

Application Process:

Interested candidates are encouraged to submit a resume, cover letter and a list of three professional references to hr@sbnbcc.org. If we feel you are a good match for the position, you will be contacted to schedule an interview.

Additional Information:

All qualified applicants will receive consideration for employment without regard to race; color; ancestry; national origin; religion/creed; sex/sexual orientation; gender; gender identity/expression, transition; political affiliation or beliefs; disability, medical condition, generic information, marital status; military/veteran status; pregnancy and conditions related thereto.; or any other characteristic protected by law (as defined by the California Fair Employment and Housing Act — Government Code Section 12900-12996), except where such discrimination is based on a bona fide occupational qualification.