Pacific Health Group
Enhanced Care Management Program Manager (Southern California)
Pacific Health Group, San Diego, California, United States, 92189
Enhanced Care Management Program Manager (Southern California)
Join to apply for the
Enhanced Care Management Program Manager (Southern California)
role at
Pacific Health Group Enhanced Care Management Program Manager (Southern California)
3 days ago Be among the first 25 applicants Join to apply for the
Enhanced Care Management Program Manager (Southern California)
role at
Pacific Health Group ECM Program Manager at Pacific Health Group
Directly supervise and mentor Lead Care Managers across multiple counties in Southern California Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion Conduct regular performance evaluations and provide constructive feedback to optimize team performance Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations
Job Description
ECM Program Manager at Pacific Health Group
Key Responsibilities
Team Leadership & Supervision
Directly supervise and mentor Lead Care Managers across multiple counties in Southern California Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion Conduct regular performance evaluations and provide constructive feedback to optimize team performance Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations
Program Development & Quality Assurance
Establish comprehensive benchmarks and performance metrics for the ECM program Design and implement quality assurance protocols to monitor service delivery and member outcomes Develop standardized workflows and procedures to ensure consistency across counties Example: Create a dashboard tracking key performance indicators such as member engagement rates, hospital readmission reductions, and health outcome improvements with monthly reporting to stakeholders Example: Review staff performance metrics during weekly one-on-ones, identifying trends and providing real-time guidance for improvement opportunities Example: Use weekly team meetings to review program-wide performance data and collaboratively develop improvement strategies
Member Services Oversight
Ensure Lead Care Managers conduct regular in-person visits with ECM members Monitor frequency and quality of member interactions through documentation reviews and ride-alongs Implement strategies to improve member engagement and satisfaction Example: Institute a monthly audit process reviewing 10% of member files to verify appropriate in-person visit frequency, comprehensive assessment completion, and personalized care planning Example: Utilize weekly one-on-one meetings to review challenging member cases and collaboratively develop intervention strategies with Lead Care Managers Example: Dedicate time during weekly team meetings for case presentations of complex members, allowing for multi-perspective problem-solving and shared learning
Cross-Functional Collaboration
Serve as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizations Collaborate with data analytics team to track program outcomes and identify improvement opportunities Partner with compliance department to ensure adherence to regulatory requirements Example: Establish quarterly collaborative meetings with hospital discharge planners to improve care transitions and reduce readmission rates for high-risk members Example: Provide updates during weekly team meetings on cross-departmental initiatives and partnership opportunities
Budget & Resource Management
Develop and manage program budget, including staffing, operational costs, and member support resources Allocate resources efficiently across counties based on member needs and program priorities Track and report on program expenditures and return on investment Example: Create a resource allocation model that adjusts staffing levels based on member acuity and geographic considerations while maintaining cost-effectiveness
Program Innovation & Growth
Identify opportunities to enhance program effectiveness through innovative approaches Develop proposals for program expansion or new service offerings Stay current on industry best practices and integrate relevant approaches Example: Pilot a telehealth component to supplement in-person visits for rural members, evaluating impact on engagement and outcomes before regional implementation
Additional Examples Of ECM Program Manager Role
Weekly Meeting Management
Design an effective weekly team meeting structure that balances operational updates, case reviews, professional development, and team building Rotate meeting facilitation responsibilities among Lead Care Managers to develop leadership skills across the team Implement a "bright spots" segment in weekly team meetings where staff share success stories and effective intervention strategies Use weekly team meetings as an opportunity to recognize staff achievements and celebrate program milestones
One-on-One Meeting Management
Maintain a structured agenda template for weekly one-on-ones that includes caseload review, performance metrics discussion, professional development check-in, and resource needs assessment Document key discussion points and action items from each one-on-one meeting, with follow-up tracking to ensure completion Use these meetings to identify systemic issues that may require program-wide solutions or policy adjustments Develop individualized coaching approaches for each Lead Care Manager based on their learning style, experience level, and areas for growth
Team Leadership & Development
Implement a structured mentorship program where you pair new Lead Care Managers with experienced ones across different counties to facilitate knowledge transfer and consistent practice standards Lead quarterly regional training sessions focused on complex case management strategies, addressing topics like managing members with co-occurring behavioral health and chronic medical conditions Create a cross-county peer learning community where Lead Care Managers can share best practices and problem-solve together
Operational Management
Lead Monday morning operational huddles with all Lead Care Managers to review the week's priorities, address staffing challenges, and highlight critical member situations requiring attention Review and analyze weekly performance dashboards showing county-by-county metrics on member engagement, visit completion, and outcome measures Conduct bi-weekly case conferences focused on complex members who require multi-disciplinary approaches or have challenging barriers to engagement
Stakeholder Management
Prepare and present quarterly program performance reports to health plan leadership, demonstrating impact on utilization, quality measures, and member outcomes Develop and maintain relationships with county behavioral health directors to improve coordination for members with mental health and substance use disorders Create and distribute a monthly ECM program newsletter highlighting success stories, best practices, and upcoming initiatives for internal and external stakeholders
Qualifications
Education & Experience
Master's, or Bachelor's degree in Healthcare Administration, Public Health, Nursing, or related field 5+ years of experience in healthcare management, with at least 3 years in care/case management services Minimum of 2 years of direct experience working in Enhanced Care Management programs or equivalent intensive care management initiatives Demonstrated understanding of ECM program requirements, populations of focus, and care management best practices specific to high-need Medicaid populations Previous supervisory experience managing teams across multiple locations
Knowledge & Skills
Thorough understanding of care management principles and practices Strong knowledge of healthcare delivery systems and Medicaid/Medicare programs In-depth familiarity with California's ECM program structure, reporting requirements, and quality metrics Experience interpreting and implementing ECM policy guidance and requirements from the Department of Health Care Services Excellent analytical skills to evaluate program effectiveness and implement improvements Advanced proficiency in healthcare data analysis and quality improvement methodologies
Personal Attributes
Exceptional leadership abilities with demonstrated success in team development Strong communication and interpersonal skills Ability to manage multiple priorities in a fast-paced environment Commitment to person-centered care and health equity
Working Conditions
Primary office location in San Marcos with regular travel (30-40%) to county sites throughout Southern California Occasional evening/weekend availability for special program initiatives or urgent situations
This position offers an opportunity to make a significant impact on vulnerable populations through innovative care management approaches while leading a dedicated team of healthcare professionals across Southern California.
Compensation And Benefits
Salary Range: $80,000$90,000 annually Hours: Monday through Friday; some evenings and some weekends required Benefits: 401(k), health/dental/vision insurance, life insurance, paid time off Additional: Mileage reimbursement at the IRS standard rate
Job Type: Full-time
Pay: $80,000.00 - $90,000.00 per year
Benefits
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance
Work Location: On the road
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Full-time Job function
Job function
Health Care Provider Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Pacific Health Group by 2x Get notified about new Care Manager jobs in
San Diego, CA . Supervisor, Food Services (Casual) - Kitchen
Care Manager, Health Plan, Part Time, Licensed/Remote in CA
Care Manager, Health Plan - Licensed/Remote in CA
Hospice Director of Patient Care Services (RN)
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
(RN) Care Manager - East Campus - 135896
San Diego County, CA $23.00-$28.00 2 weeks ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr
Join to apply for the
Enhanced Care Management Program Manager (Southern California)
role at
Pacific Health Group Enhanced Care Management Program Manager (Southern California)
3 days ago Be among the first 25 applicants Join to apply for the
Enhanced Care Management Program Manager (Southern California)
role at
Pacific Health Group ECM Program Manager at Pacific Health Group
Directly supervise and mentor Lead Care Managers across multiple counties in Southern California Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion Conduct regular performance evaluations and provide constructive feedback to optimize team performance Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations
Job Description
ECM Program Manager at Pacific Health Group
Key Responsibilities
Team Leadership & Supervision
Directly supervise and mentor Lead Care Managers across multiple counties in Southern California Conduct weekly one-on-one meetings with each staff member to provide individualized guidance, address challenges, and ensure alignment with program goals Facilitate weekly team meetings to promote collaboration, ensure consistent communication, address program updates, and foster team cohesion Conduct regular performance evaluations and provide constructive feedback to optimize team performance Example: Develop individualized professional development plans for each Lead Care Manager based on their strengths and growth areas, with quarterly check-ins to assess progress Example: Use weekly one-on-one meetings to review Lead Care Managers' caseloads, discuss challenging members, and provide coaching on complex care management scenarios Example: Structure weekly team meetings to include program updates, case reviews, success story sharing, and collaborative problem-solving for challenging situations
Program Development & Quality Assurance
Establish comprehensive benchmarks and performance metrics for the ECM program Design and implement quality assurance protocols to monitor service delivery and member outcomes Develop standardized workflows and procedures to ensure consistency across counties Example: Create a dashboard tracking key performance indicators such as member engagement rates, hospital readmission reductions, and health outcome improvements with monthly reporting to stakeholders Example: Review staff performance metrics during weekly one-on-ones, identifying trends and providing real-time guidance for improvement opportunities Example: Use weekly team meetings to review program-wide performance data and collaboratively develop improvement strategies
Member Services Oversight
Ensure Lead Care Managers conduct regular in-person visits with ECM members Monitor frequency and quality of member interactions through documentation reviews and ride-alongs Implement strategies to improve member engagement and satisfaction Example: Institute a monthly audit process reviewing 10% of member files to verify appropriate in-person visit frequency, comprehensive assessment completion, and personalized care planning Example: Utilize weekly one-on-one meetings to review challenging member cases and collaboratively develop intervention strategies with Lead Care Managers Example: Dedicate time during weekly team meetings for case presentations of complex members, allowing for multi-perspective problem-solving and shared learning
Cross-Functional Collaboration
Serve as liaison between the ECM program and healthcare partners, including hospitals, primary care providers, and community organizations Collaborate with data analytics team to track program outcomes and identify improvement opportunities Partner with compliance department to ensure adherence to regulatory requirements Example: Establish quarterly collaborative meetings with hospital discharge planners to improve care transitions and reduce readmission rates for high-risk members Example: Provide updates during weekly team meetings on cross-departmental initiatives and partnership opportunities
Budget & Resource Management
Develop and manage program budget, including staffing, operational costs, and member support resources Allocate resources efficiently across counties based on member needs and program priorities Track and report on program expenditures and return on investment Example: Create a resource allocation model that adjusts staffing levels based on member acuity and geographic considerations while maintaining cost-effectiveness
Program Innovation & Growth
Identify opportunities to enhance program effectiveness through innovative approaches Develop proposals for program expansion or new service offerings Stay current on industry best practices and integrate relevant approaches Example: Pilot a telehealth component to supplement in-person visits for rural members, evaluating impact on engagement and outcomes before regional implementation
Additional Examples Of ECM Program Manager Role
Weekly Meeting Management
Design an effective weekly team meeting structure that balances operational updates, case reviews, professional development, and team building Rotate meeting facilitation responsibilities among Lead Care Managers to develop leadership skills across the team Implement a "bright spots" segment in weekly team meetings where staff share success stories and effective intervention strategies Use weekly team meetings as an opportunity to recognize staff achievements and celebrate program milestones
One-on-One Meeting Management
Maintain a structured agenda template for weekly one-on-ones that includes caseload review, performance metrics discussion, professional development check-in, and resource needs assessment Document key discussion points and action items from each one-on-one meeting, with follow-up tracking to ensure completion Use these meetings to identify systemic issues that may require program-wide solutions or policy adjustments Develop individualized coaching approaches for each Lead Care Manager based on their learning style, experience level, and areas for growth
Team Leadership & Development
Implement a structured mentorship program where you pair new Lead Care Managers with experienced ones across different counties to facilitate knowledge transfer and consistent practice standards Lead quarterly regional training sessions focused on complex case management strategies, addressing topics like managing members with co-occurring behavioral health and chronic medical conditions Create a cross-county peer learning community where Lead Care Managers can share best practices and problem-solve together
Operational Management
Lead Monday morning operational huddles with all Lead Care Managers to review the week's priorities, address staffing challenges, and highlight critical member situations requiring attention Review and analyze weekly performance dashboards showing county-by-county metrics on member engagement, visit completion, and outcome measures Conduct bi-weekly case conferences focused on complex members who require multi-disciplinary approaches or have challenging barriers to engagement
Stakeholder Management
Prepare and present quarterly program performance reports to health plan leadership, demonstrating impact on utilization, quality measures, and member outcomes Develop and maintain relationships with county behavioral health directors to improve coordination for members with mental health and substance use disorders Create and distribute a monthly ECM program newsletter highlighting success stories, best practices, and upcoming initiatives for internal and external stakeholders
Qualifications
Education & Experience
Master's, or Bachelor's degree in Healthcare Administration, Public Health, Nursing, or related field 5+ years of experience in healthcare management, with at least 3 years in care/case management services Minimum of 2 years of direct experience working in Enhanced Care Management programs or equivalent intensive care management initiatives Demonstrated understanding of ECM program requirements, populations of focus, and care management best practices specific to high-need Medicaid populations Previous supervisory experience managing teams across multiple locations
Knowledge & Skills
Thorough understanding of care management principles and practices Strong knowledge of healthcare delivery systems and Medicaid/Medicare programs In-depth familiarity with California's ECM program structure, reporting requirements, and quality metrics Experience interpreting and implementing ECM policy guidance and requirements from the Department of Health Care Services Excellent analytical skills to evaluate program effectiveness and implement improvements Advanced proficiency in healthcare data analysis and quality improvement methodologies
Personal Attributes
Exceptional leadership abilities with demonstrated success in team development Strong communication and interpersonal skills Ability to manage multiple priorities in a fast-paced environment Commitment to person-centered care and health equity
Working Conditions
Primary office location in San Marcos with regular travel (30-40%) to county sites throughout Southern California Occasional evening/weekend availability for special program initiatives or urgent situations
This position offers an opportunity to make a significant impact on vulnerable populations through innovative care management approaches while leading a dedicated team of healthcare professionals across Southern California.
Compensation And Benefits
Salary Range: $80,000$90,000 annually Hours: Monday through Friday; some evenings and some weekends required Benefits: 401(k), health/dental/vision insurance, life insurance, paid time off Additional: Mileage reimbursement at the IRS standard rate
Job Type: Full-time
Pay: $80,000.00 - $90,000.00 per year
Benefits
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance
Work Location: On the road
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Full-time Job function
Job function
Health Care Provider Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Pacific Health Group by 2x Get notified about new Care Manager jobs in
San Diego, CA . Supervisor, Food Services (Casual) - Kitchen
Care Manager, Health Plan, Part Time, Licensed/Remote in CA
Care Manager, Health Plan - Licensed/Remote in CA
Hospice Director of Patient Care Services (RN)
Behavioral Health Care Manager Remote, must be Licensed and Reside in California
(RN) Care Manager - East Campus - 135896
San Diego County, CA $23.00-$28.00 2 weeks ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr