ECM Case Manager

Key Responsibilities & Qualifications:

Provide Enhanced Care Management (ECM) services to members with complex medical, behavioral health, and/or social needs.
Manage an assigned caseload while maintaining consistent member engagement, outreach, and follow-up.
Conduct comprehensive assessments and identify medical, behavioral health, and social service needs.
Develop, maintain, and update individualized care plans based on member needs and established goals.
Hands-on experience completing and documenting POFs, including gathering required member information and ensuring accurate and timely completion, is strongly preferred.
Complete required screenings, assessments, specialty summaries, case notes, and other ECM documentation within established timelines.
Coordinate care across primary care, specialty care, behavioral health, community organizations, and other service providers.
Track referrals, appointments, care gaps, member progress, and follow-up activities.
Assist members in navigating healthcare systems and accessing appropriate services and community resources.
Identify and address social determinants of health, including housing, food insecurity, transportation, benefits, and other barriers to care.
Maintain accurate, timely, and compliant documentation within the electronic health record (EHR/EMR).
Experience working with Medi-Cal, managed care, community health, ECM, or complex/vulnerable populations is strongly preferred.
EPIC experience is highly preferred.
Knowledge of medical terminology is preferred.
Strong communication, organization, documentation, time management, and member engagement skills are required.