Project Manager – Community Wellness and Coordinated Care – 211

Position: Project Manager, Community Wellness and Coordinated Care

Exemption Status: Non-Exempt

Reports to: Associate Director, Community Wellness and Coordinated Care

Base Rate: $33.00/hr + $1.00 Bilingual incentive upon passing certification – currently hourly until team is hired

Summary: Project Manager oversees and directs the Coordinated Care program team, under CalAIM Enhanced Care Management (ECM) and other initiatives, ensuring the delivery of high-quality case management services to high-risk populations. This role involves strategic leadership of Case Manager III, program development, quality assurance, and collaboration with healthcare partners while maintaining compliance with CalAIM requirements and organizational objectives.

Key Responsibilities:

1. Supervision and Case Management Oversight
   1. Assign cases to case managers based individual capacity and case acuity
   2. Coach and mentor case managers on client assessments, care planning, and crisis intervention
   3. Meet with case managers on a weekly or bi-weekly basis to provide supervision and discuss cases
   4. Proactively address performances concerns, and implement corrective actions when necessary
   5. Monitor case loads to identify issues and ensure interventions
   6. Review case plans and documentation to be submit for final approval and clinical consultation
   7. Ensure team observance of divisions standards and case management practices
   8. Identify and inform division management of any areas of improvement
2. Client Engagement and Support:
   1. Assist in outreach and engagement efforts to connect with coordinated care clients
   2. Conduct initial screenings and assist with comprehensive assessments under the guidance of the Community Wellness and Coordinated Care Associate Director
   3. Provide regular check-ins with clients and their care teams, to monitor progress and identify emerging needs
   4. Support clients in navigating the healthcare system and accessing community resources
   5. Oversee the client grievance process, including serving as the initial point of escalation
3. Care Plan Implementation:
   1. Assist the Community Wellness and Coordinated Care Associate Director in developing and updating client care teams and person-centered care plans
   2. Assist case managers in helping clients understand and work towards their care plan goals
   3. Monitor client progress and report any significant changes or concerns to the Community Wellness and Coordinated Care Associate Director
4. Care Coordination and Service Navigation:
   1. Assist in providing case management services as needed
   2. Schedule and coordinate medical appointments, transportation, and other support services for clients
   3. Accompany clients to healthcare appointments when necessary
   4. Advocate for client needs and ensure appropriate services are accessed internally and externally
   5. Assist in coordinating care across multiple providers and systems
   6. Help clients access community resources and support services
   7. Facilitate communication between clients and their care teams
   8. Prioritize tasks and manage time effectively to meet client needs and program requirements
5. Health Education and Coaching:
   1. Provide basic health education and self-management support to clients
   2. Coach clients on medication adherence and lifestyle modifications
   3. Assist in implementing health promotion strategies developed by the Community Wellness and Coordinated Associate Director
6. Documentation and Reporting:
   1. Maintain accurate and timely documentation of all client and care team interactions and services provided
   2. Use appropriate billing codes for services rendered
   3. Contribute to the preparation of reports and care summaries as required
7. Care Transitions Support:
   1. Assist in managing care transitions, such as hospital discharges or changes in living situations
   2. Help ensure continuity of care during transitions by coordinating with various providers and support systems
8. Team Collaboration and Communication:
   1. Participate in regular team meetings and case conferences
   2. Collaborate with other care teams across departments to identify and address complex client situations
   3. Maintain open communication with the Associate Director and other team members
   4. Escalate complex issues or concerns to the Associate Director as appropriate
9. Compliance and Quality Improvement:
   1. Adhere to all program policies, procedures, and contractual requirements
   2. Participate in quality improvement initiatives and training programs
   3. Ensure training initiatives adopted into practice are implemented by case managers
   4. Maintain client confidentiality and follow all regulations
   5. Track client volume, program needs and referral flow and source to assist with program evaluation

Qualifications:

• Bachelor’s degree in social work, public health, nursing, or related field preferred; or equivalent experience
• Minimum of 2 years of experience in care coordination, case management, or related field
• Knowledge of Medi-Cal, benefits programs, and community resources
• Strong interpersonal and communication skills
• Cultural competency and ability to work with diverse populations
• Proficiency in care management documentation systems
• Successful criminal clearance required and maintained, including but not limited to California Department of Justice (DOJ), Federal Bureau of Investigation (FBI, Child Abuse Index and Department of Motor Vehicles (DMV)
• Proof of a valid California Driver’s License, reliable transportation, proof of automobile insurance (listed as covered), pass and maintain driving approval as required by our insurer