Job Description
Wage band range $66,560.00 - $85,000.00 annual; however, starting pay is ultimately determined by the scope of the position, the candidate's relevant experience, and internal equity. Bilingual in Spanish, preferred and position is eligible to test for a bilingual pay incentive. Responsible for the operational success of the Enhanced Care Management Program and other assigned community-based services programs, ensuring seamless team management, development, program delivery, quality control and evaluation. ECM services provide a whole-person approach to children, youth and families experiencing complex medical and psychosocial challenges to minimize the likelihood of preventable hospital and emergency department admissions. Services include outreach and engagement, providing person-centered care coordination, completing assessments, developing care plans, and providing linkages to medical, psychiatric, social, educational and other services as needed. We are a diverse and inclusive team providing excellent services to all our surrounding communities. Our team members are empowered to share their identities, ideas, and perspectives. A culture built on diversity, equity and inclusivity is essential to creating a safe and healing environment at Casa Pacifica. Essential Duties To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. - Ensure assigned programs are in compliance with all agency policies and procedures, including adhering to all state and/or federal funding requirements and licensing/contractual requirements.
- Support ongoing communication and certification procedures with managed care providers and other contractual partners.
- Participate in regular meetings with managed care programs, other contract liaisons, and community partners.
- Seek opportunities to build strong relationships with health care providers, local and community organizations, and government agencies to support enrolled clients.
- Oversee reporting, billing, and quality assurance in partnership with other departments.
- Ensure continuous availability of clinical supervision, consultation, and support as required during and after normal business hours.
- Manage the development and implementation of comprehensive, coordinated health service plans for all covered families in assigned programs.
- Ensure all staff are provided with individualized orientation plans, training plans, direct field observations and performance evaluations.
- Provide direct supervision to program staff. Is responsible for providing leadership development to all program staff and partners with the Program Manager/Assistant Director of CBS to support and provide leadership for community-based programs and the agency.
- Ensure that client insurance eligibility and accuracy of the Targeted Engagement List/client File, and timely tracking of outreach activities is confirmed monthly.
- Ensure timely, high-quality documentation of services in accordance with contractual requirements including ensuring charts are audit ready at all times.
- Develop and monitor staff schedules to ensure program coverage and budgetary compliance.
- Manage collection of process and outcome data and utilizes the data to improve program procedures, identify needs, and highlight program successes.
- Reviews and approves payment of expenses and ensures compliance with approved budgets. Ensures resources are sufficient to support assigned programs.
- Manage to ensure fiscal viability of the program.
- Facilitate and participate in case conferences and team meetings to monitor individual needs and services plans to ensure effective quality clinical service delivery
- Works collaboratively across agency management team to integrate across program activities and functions.
- Provides direct services when needed and can hold a caseload as needed.
- Participates in the Community Based Services on-call system.
- Maintain patient privacy, including protecting confidentiality, safeguarding the integrity and availability, and limiting the use and disclosure of patient Protected Health Information (PHI) to authorized individuals and entities.
Supervisory Responsibilities - Responsible for the overall direction, coordination, and evaluation of the direct and indirect reports.
- Carry out supervisory responsibilities in accordance with the organization's policies and applicable laws.
- Responsibilities include interviewing, hiring (in collaboration with Program Manager and Director), and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
- This job provides direct supervision to 3-10 assigned staff
Minimum Requirements - Five years of outpatient medical, community health service delivery, behavioral practice management, or related healthcare experience, with two years of supervisory experience
- Bachelor’s degree
Preferred Qualifications - Multilingual capabilities preferred, but not required
- Prior experience as a Community Health Worker, Peer Support Specialist, Medical Assistant or similar role a plus
Other Skills And Abilities - Understanding of commercial insurance regulations and practices
- Understanding of current utilization/quality management principles, techniques and procedures
- Possesses negotiation and advocacy skills and abilities.
- Strong computer skills - Word, Excel, Outlook, Electronic Health Record
- Excellent written and verbal communication skills.
- Ability to maintain professionalism and confidentiality in all aspects of position.
- Strong interpersonal and organizational skills
- Self-starter, creative thinker with strong social and customer service skills
- Ability to manage several projects at one time. Organized and able to function well in a busy environment including the ability to switch gears easily and multi-task.
- Demonstrated ability to work collaboratively, yet function independently.
- Ability to interact with children and their families in a nurturing way with a positive and patient demeanor.
- Valid California Driver's License with excellent driving record. Use of personal car at times with mileage reimbursement. Must have proof of insurance. Must maintain a positive driving record; reports tickets and driving points to immediate supervisor and Human Resources as they occur. Abides by Casa Pacifica travel policy.
Language Skills: Ability to read and interpret documents such as insurance requirements, authorizations, and coverages, safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Mathematical Skills : Ability to calculate figures and amounts such as discounts, interest, percentages, and ratios. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. What We Offer Casa Pacifica strongly believes in providing our employees with a comprehensive and competitive total benefits package that will support them across the many needs that arise in life. In addition to the salary information listed above, employees within this position will also be eligible for the following: - Comprehensive Benefits package,
- 401k auto enrollment at 3% with up to 5% fully vested employer matching contributions made after first year of service
- 9 paid holidays
- Medical, Dental & Vision Insurance options
- Flexible Spending and Dependent care programs
- Excellent Training opportunities – including opportunities for CEUs
- Education/Tuition Assistance programs
- Group Discount Pet Insurance
- Aflac Hospital, Critical Illness, Accidental & Dental supplemental plan options
- Employee Assistance Program (EAP)
- Free Confidential Crisis Line 24/7, 365 days a year
- 4 face-to-face or telephonic sessions per issue, i.e.,
- Stress, Anxiety, Depression
- Life transitions
- Grief and Loss
- Divorce
- Conflict Resolution
- Substance Abuse
- Work-Life Counseling
- Free Legal and Financial Consultations
- Identity Theft Recovery Services
Casa Pacifica is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. All applicants will be given full consideration under state, local, and federal law.
Job Tags
Contract work, Local area, Immediate start, Flexible hours,