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Enhanced Care Management (ECM) Program Manager Hybrid Northern CA
ZipRecruiter, San Jose, California, United States, 95199
Job DescriptionJob Description
Pacific Health Group is seeking an experienced Enhanced Care Management (ECM) Program Manager to lead a dedicated team of Care Managers across multiple Northern California counties. This individual will drive program development, ensure quality service delivery, and collaborate with diverse healthcare partners to improve outcomes for high-need Medicaid populations.
Key Responsibilities
Team Leadership & Supervision
Directly supervise and mentor Lead Care Managers in multiple counties
Conduct weekly one-on-one meetings to provide individualized guidance, address challenges, and align on program goals
Facilitate weekly team meetings to promote collaboration, share updates, and foster team cohesion
Perform regular performance evaluations, offering constructive feedback to optimize team effectiveness
Example: Develop individualized professional development plans for each Lead Care Manager and conduct quarterly check-ins to track growth.
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
Create standardized workflows and procedures to ensure consistency across counties
Example: Maintain a dashboard of key performance indicators (for instance, member engagement and hospital readmission rates) and share reports with stakeholders.
Member Services Oversight
Ensure Lead Care Managers conduct regular in-person visits with ECM members
Monitor member interactions through documentation reviews and occasional ride-alongs
Implement strategies to improve member engagement and satisfaction
Example: Audit a sample of member files each month to verify in-person visit frequency, comprehensive assessments, and personalized care plans.
Cross-Functional Collaboration
Serve as primary liaison between the ECM program and healthcare partners, including hospitals and community organizations
Work closely with data analytics to track outcomes and identify improvement opportunities
Partner with compliance to ensure adherence to regulatory requirements
Example: Organize collaborative meetings with hospital discharge planners to coordinate care transitions and reduce readmission risks.
Budget & Resource Management
Develop and manage the program budget, including staffing, operational costs, and resource needs
Allocate resources efficiently based on member acuity and county priorities
Track and report on program expenditures and return on investment
Example: Create a staffing model that adjusts resource levels based on geographic demands and member needs.
Program Innovation & Growth
Identify and implement innovative approaches to enhance program effectiveness
Propose strategies for program expansion or new service offerings
Stay updated on industry best practices and integrate relevant methods into the ECM program
Example: Pilot a telehealth component to supplement in-person visits for rural members, measuring impact on engagement and outcomes.
Qualifications
Education & Experience
Bachelor’s degree in Healthcare Administration, Public Health, Nursing, or a related field
Five or more years of healthcare management experience, with at least three years in care management
Minimum of two years of direct experience in ECM programs or equivalent intensive care management initiatives
Demonstrated understanding of ECM program requirements, populations of focus, and best practices for high-need Medicaid populations
Proven supervisory experience managing teams across multiple locations
Knowledge & Skills
Thorough knowledge of care management principles and practices
Strong familiarity with healthcare delivery systems and Medicaid or Medicare programs
Expertise in California’s ECM structure, including reporting requirements and quality metrics
Ability to interpret and implement ECM policy guidance from the Department of Health Care Services
Excellent analytical and quality improvement skills, with the ability to leverage healthcare data
Advanced leadership, communication, and interpersonal abilities
Personal Attributes
Exceptional leadership and team-building skills
Strong communication and organizational abilities
Ability to manage multiple priorities in a fast-paced environment
Commitment to person-centered care and health equity
Working Conditions
Primary office based in Sacramento
Regular travel (approximately thirty to forty percent) to county sites across Northern California
Occasional evening or weekend availability for special initiatives or urgent program needs
Benefits
401(k)
Dental Insurance
Health Insurance
Vision Insurance
Life Insurance
Paid Time Off (PTO)
Why Join Pacific Health Group?
Impactful Work: Make a tangible difference in the lives of vulnerable populations through advanced care management.
Leadership Opportunity: Oversee a multi-county team, mentor emerging leaders, and shape an ECM program recognized for quality and innovation.
Growth & Development: Access ongoing professional development and the opportunity to pioneer new initiatives in a rapidly evolving healthcare landscape.
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