About this position
JOB SUMMARY: Under the direct supervision of the ECM Lead, the ECM Care Specialist
is responsible for overseeing care coordination of high-need members enrolled in MediCal managed care. Specialist will complete care planning in collaboration with the
participant including assessments to identify health, behavioral and social barriers,
provide intensive case management and linkages to social services, and assist
participants with navigating the healthcare system. The Specialist will utilize motivational
interviewing to engage participants and support their motivation to better manage
their own chronic conditions.
Requirements
ESSENTIAL FUNCTIONS:
- Conduct an in-depth assessment with participants including identifying participant’s referring chronic condition(s), Primary Health Concern (PHC), housing stability, Social Determinants of Health (SDoH) needs, preferences, and barriers on a biannual basis.
- Complete participant-centered treatment goals in collaboration with participants and review progress in meeting goals routinely to encourage better management of health.
- Provide support and education to participants to assist them in adhering to medical recommendations and taking medications as prescribed.
- Communicate with participant’s health plan and service providers to ensure coordination of services and to advocate for participants needs or preferences.
- Participate in Interdisciplinary Care Team (ICT) meetings on a regular basis to ensure the quality and appropriateness of services being provided to the participant, and to better support participant’s ability access needed health care services and community resources.
- Expand and maintain knowledge of social service providers, government assistance, and healthcare systems; Connect individuals to resources.
- Attend and actively participate in weekly supervision, training and meetings as scheduled to ensure staff’s understanding and ability to apply best practices and evidence-based practices while working with participants.
- Review referrals from contracting agency daily and assign them to Community Health Workers within 24 hours of original assignment.
- Complete all required records and documents according to funder expectations; enter, track and maintain log of daily activities conducted using data tracking tool.
- Other duties as assigned.
QUALIFICATIONS:
- Bachelor’s degree required or a combination of skills and experience in lieu of degree.
- Bi-Lingual English and Spanish fluency required.
- Experience navigating health and social service systems including providing warm hand-offs, experience with outreach a plus.
- Experience linking people with complex health, behavioral health, and social needs to community resources.
- Excellent customer service, communication, and organization skills; ability to communicate complex information effectively.
- Demonstrated ability to support, coach, and motivate participants to reach their goals.
- Must have reliable transportation to commute to off-site meetings/trainings and occasional home visits.
- Ability to manage time effectively to complete tasks and meet deadlines.
- Experience using electronic technology (laptop, tablet, cell phone) and Microsoft Office Suite (Excel, Word, and Outlook) required.
- Strong organizational and follow-through skills; adept at tracking data and program outcomes.
- Experience working with individuals with diverse ethnic backgrounds.
- Proven ability to work independently and as an effective and collaborative member
- of a team.
PHYSICAL REQUIREMENTS:
- Employees may regularly need to lift up to ten (10) pounds.
- While performing the duties of this job, the employee is regularly required to identify, communicate, and exchange information.
- Expected to travel to community meetings, participant homes or other agencies.
- May experience traumatic situations including psychiatric, traumatized, and deceased participants.
TIME COMMITMENT: Full time 70 hours per pay period (9/70 per pay period or 32/38 hours per week based on organizational needs); may include some evening and weekends and local travel.
All positions contingent on continued funding.