COPE Health Solutions
Patient Care Navigator II, Enhanced Care Management (ECM)
COPE Health Solutions, Los Angeles, California, United States, 90079
Patient Care Navigator II, Enhanced Care Management (ECM)
Location: Los Angeles (onsite). Travel up to 80%. Salary: $23.00–$27.00 per hour. Full time, regular work type. Exempt under FLSA. Reports to ECM Program Manager/Director. No direct reports. Description
The Patient Care Navigator II blends care coordination responsibilities with community engagement to support the Cal AIM Enhanced Care Management (ECM) program. Maintains an assigned caseload of ECM members, coordinates medical, behavioral health, and social services, and engages members continuously to meet their needs. Works closely with RN Care Managers, Licensed Vocational Nurses, Behavioral Health Care Managers, Community Health Workers, health providers, and community partners to ensure appropriate access to care. Care Coordination & Caseload Management
Maintain an assigned caseload of ECM members in accordance with Medi‑Cal guidelines. Provide ongoing outreach, engagement, and follow‑up with members via phone and in‑person visits, based on assigned tier level and member need. Conduct face‑to‑face visits as required by member risk tier. Offer care coordination support, including appointment scheduling, transportation arrangements, referral tracking, and follow‑up. Ensure smooth transitions of care, coordinating with hospitals and facilities related to admissions and discharges. Encourage member self‑efficacy and shared decision‑making in care planning through motivational interviewing. Connect members to community resources and social services, including housing, food, transportation, and other identified needs. Collab with RNCMs, LVNs, BHCMs, CHWs, and other care team members regarding members’ care needs. Support care team members with delegated clerical tasks as appropriate. Assign members to appropriate case managers based on risk category and available clinical data. Track and ensure completion of required assessments and screenings, including Health Assessments and Shared Care Plans. Maintain timely, accurate documentation in the ECM care management platform in compliance with program requirements. Additional Responsibilities
Attend meetings with providers, health plans, community partners, and internal stakeholders. Complete additional tasks and projects assigned to support ECM program goals. Qualifications
High school diploma or equivalent; associate’s or bachelor’s degree in health administration, public health, social work, sociology, psychology, or related field preferred. Experience in care coordination, community health work, case management, or social services. Experience working with high‑risk or vulnerable populations. Strong interpersonal, organizational, and communication skills. Ability to manage a caseload and prioritize multiple tasks in a fast‑paced environment. Comfortable with field‑based, community, and home visits. Proficiency with electronic health records and care management platforms. Reliable transportation with active insurance coverage. Preferred: Experience within CalAIM, ECM, managed care, or Medicaid programs; knowledge of community‑based resources and social service systems; bilingual abilities. Benefits
COPE Health Solutions offers comprehensive, affordable insurance plans for employees and their families, a yearly wellness stipend, and a paid parental leave program. Learn more about our benefits
here . About COPE Health Solutions
COPE Health Solutions is a national tech‑enabled services firm that powers success for health plans and providers in risk arrangements. Our NCQA‑certified population health management platform, along with a highly experienced team, drives financial performance and quality outcomes for payers and providers. For more information, visit
CopeHealthSolutions.com . To Apply
Visit
COPE Careers
to apply for this position or for more information.
#J-18808-Ljbffr
Location: Los Angeles (onsite). Travel up to 80%. Salary: $23.00–$27.00 per hour. Full time, regular work type. Exempt under FLSA. Reports to ECM Program Manager/Director. No direct reports. Description
The Patient Care Navigator II blends care coordination responsibilities with community engagement to support the Cal AIM Enhanced Care Management (ECM) program. Maintains an assigned caseload of ECM members, coordinates medical, behavioral health, and social services, and engages members continuously to meet their needs. Works closely with RN Care Managers, Licensed Vocational Nurses, Behavioral Health Care Managers, Community Health Workers, health providers, and community partners to ensure appropriate access to care. Care Coordination & Caseload Management
Maintain an assigned caseload of ECM members in accordance with Medi‑Cal guidelines. Provide ongoing outreach, engagement, and follow‑up with members via phone and in‑person visits, based on assigned tier level and member need. Conduct face‑to‑face visits as required by member risk tier. Offer care coordination support, including appointment scheduling, transportation arrangements, referral tracking, and follow‑up. Ensure smooth transitions of care, coordinating with hospitals and facilities related to admissions and discharges. Encourage member self‑efficacy and shared decision‑making in care planning through motivational interviewing. Connect members to community resources and social services, including housing, food, transportation, and other identified needs. Collab with RNCMs, LVNs, BHCMs, CHWs, and other care team members regarding members’ care needs. Support care team members with delegated clerical tasks as appropriate. Assign members to appropriate case managers based on risk category and available clinical data. Track and ensure completion of required assessments and screenings, including Health Assessments and Shared Care Plans. Maintain timely, accurate documentation in the ECM care management platform in compliance with program requirements. Additional Responsibilities
Attend meetings with providers, health plans, community partners, and internal stakeholders. Complete additional tasks and projects assigned to support ECM program goals. Qualifications
High school diploma or equivalent; associate’s or bachelor’s degree in health administration, public health, social work, sociology, psychology, or related field preferred. Experience in care coordination, community health work, case management, or social services. Experience working with high‑risk or vulnerable populations. Strong interpersonal, organizational, and communication skills. Ability to manage a caseload and prioritize multiple tasks in a fast‑paced environment. Comfortable with field‑based, community, and home visits. Proficiency with electronic health records and care management platforms. Reliable transportation with active insurance coverage. Preferred: Experience within CalAIM, ECM, managed care, or Medicaid programs; knowledge of community‑based resources and social service systems; bilingual abilities. Benefits
COPE Health Solutions offers comprehensive, affordable insurance plans for employees and their families, a yearly wellness stipend, and a paid parental leave program. Learn more about our benefits
here . About COPE Health Solutions
COPE Health Solutions is a national tech‑enabled services firm that powers success for health plans and providers in risk arrangements. Our NCQA‑certified population health management platform, along with a highly experienced team, drives financial performance and quality outcomes for payers and providers. For more information, visit
CopeHealthSolutions.com . To Apply
Visit
COPE Careers
to apply for this position or for more information.
#J-18808-Ljbffr