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Job Summary :
The Manager of Community Care is responsible for the development, implementation, relationship management, oversight, and evaluation of key partnerships and community benefits targeted to improve health outcomes and member experience in alignment with the model of care and strategic initiatives. This position directs and supervises a team of Community Health Workers (CHWs) delivering services to the pediatric population.
Duties and Responsibilities:
Plans and implements programs to meet the social and emotional needs of members and members' families.
Develop and maintain a resource library of services available to children and families through their benefits and other community resources.
Partner with healthcare and social services providers across the delivery system to collaboratively address gaps related to access for pediatric members and families; these partners include: hospitals, pediatricians, Community Based Organizations (CBOs), Social Determinants of Health (SDOH) and Behavioral Health (BH) providers, and others.
Develop, implement and maintain workflows, job aids, policies and procedures for CHW staff to successfully execute their job duties.
Conduct analyses on members' utilization of services and identify opportunities for improving member experience and health outcomes.
Communicate the findings of analyses with various stakeholders, solicit input to generate well-informed recommendations, and leverage findings to develop and implement interventions or revisions to existing programs.
Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards. Complete performance evaluations in a timely manner.
Support direct staff through individual supervision, group supervision, or in vivo observation.
In collaboration with the Chief Health Officer and other departments, monitor and regularly evaluate program status, and develop and implement internal and external communications to keep key stakeholders informed (e.g., the Leadership Team, San Mateo Health Commission, HPSM network providers, and other partners).
Requirements and Qualifications:
Master's degree in social work or psychology.
Current and unrestricted CA Licensure: LCSW, LMFT, or Psychologist (required).
Minimum three (3) years of care delivery experience, preferably with Medicare/Medi-Cal experience or with pediatric populations.
Two (2) years' experience in a managerial role.
Direct operational management experience or health care project management experience in a matrixed reporting structure.
Change management, process improvement, and redesign tools.
Microsoft Office Suite applications, including Outlook, Word, Excel, Access, Visio, and PowerPoint.
Managed healthcare regulatory requirements.
Supervisory principles and practices, as well as techniques and methods to organize and manage direct reports.
Social determinants of health and principles of community health work.
Digest and synthesize regulatory requirements for diverse audiences.
Influence positive outcomes both with and without direct reporting authority over others.
Work as part of a team, exercising sound professional judgement about when to drive decision-making and when to support team decisions.
Creatively problem-solve and achieve results orientation.
Identify existing or potential problems, secure relevant information relating data from a variety of sources, determine probable cause(s), and effect appropriate solution(s).
Utilize appropriate interpersonal and conflict resolution approaches to negotiate agreement between differing individuals and groups of individuals.
Adapt to changes in requirements/priorities for daily and specialized tasks.
Analyze and interpret data, generate meaningful reports, and conduct sound analysis.
Work in a fast-paced environment with a high degree of independence
Relationship-building and interpersonal skills.
Project management and program evaluation skills.
Verbal and written communication skills.
Desired Skills and Experience
Pediatric, Social Work, Medicare, Medi-Cal, Psychology, CHWs, CBOs, SDOH, BH, LCSW, LMFT, Microsoft Office Suite, Outlook, Word, Excel, Access, Visio, PowerPoint
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Seniority level
Seniority level Mid-Senior level
Employment type
Employment type Full-time
Job function
Job function Product Management and Public Relations
Industries Insurance
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Community Care Manager