Job description
STATEMENT OF PURPOSE (THE POSITION):
Under the direction of the Administrator / Program Director, the Lead Care Manager / Community Health Worker shall work with community organizations and the community at large to promote the program and develop professional relationships to attain referrals for prospective eligible members. The Lead Care Manager shall work with eligible members with program intake and enrollment as well as conducting a thorough assessment process to develop an individualized care plan designed to meet the individualized needs of the member. The Lead Care Manager shall provide direct and indirect care management services to members and help members address their social, emotional and psychological needs along with providing and developing and /or assisting in the access of services to meet those needs. The Lead Care Manager is responsible for providing excellent quality healthcare navigation services and for fostering a culture that provides members with the highest practical level of physical, mental, and psycho social well-being and quality of life.
PRIMARY DUTIES AND RESPONSIBILITIES:
Develop professional relationships with the community to educate and promote the Among Friends Enhanced Care Management program.
Develops and promote member referrals based on community relationships.
Identifies eligible Medi-Cal recipients in need of clinical and non-clinical services.
Conducts intake processes, initial and continuing assessments for the development of individual treatment plans including goals, objectives and services designed to meet the needs of the person.
Provides full case management for ECM participants, comprehensive information, and referral resource file for the center's primary and secondary service areas along with pertinent referrals outside of service area.
Assist with coordination of member’s access to community services
Accompany member to office visits, as needed and according to MCHP guidelines.
Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the member and non-duplication of services.
Act as an advocate for participant concerns and community liaison.
Research and identify community resource available to our population. Maintain and manage community resource manuals up to date
Works in close cooperation with staff, members, and community organizations and as a member of the Multidisciplinary Team.
Records initial and final evaluations, makes daily progress notes, and schedules members for further services.
Assist in developing and providing educational and training programs for caregivers and professionals. Assisting in providing fact sheets and other information materials.
Acts as a member of assigned community committees as a representative of Among Friends ECM
Assist with agency fundraising efforts.
Consults with and advises staff members as to the relationship of social, emotional and ethnic factors to health and medical care, and as to the availability of social services in the community.
Acts as interpreter as appropriate and necessary
Attends center staff meetings and in-service educational training programs.
Additional tasks as provided
MINIMUM EDUCATIONAL REQUIREMENTS:
High school graduate or equivalent.
Bachelor’s degree in social work or related fields a plus.
SKILLS DESIRED
Bilingual a plus.
Good communication, people, outreach, and organizational, and leadership skills.
Experience in conducting case management services and familiarity with available community resources for the population served
Experience in working with varying medical conditions such as physical impairments, developmental disabilities and frail elderly populations a plus.
Ability to work independently with strong level of organizational skills
Job Type: Full-time
Schedule:
8-hour shift (Monday – Friday), Occasional weekends
Work Location: Hybrid (Office / Remote / Community)