Community Health Worker Program Manager
Pacific Health Group
Summary
Pacific Health Group is seeking a CHW Program Manager to lead, supervise, and support a team of CalAIM Community Health Workers (CHWs) delivering whole-person care to vulnerable Medi-Cal members across San Diego County, CA. The Program Manager ensures high-quality service delivery, operational efficiency, and strict adherence to CalAIM billing and documentation standards.
Job description
Role Overview & Impact
Pacific Health Group is seeking a CHW Program Manager to lead, supervise, and support a team of CalAIM Community Health Workers (CHWs) delivering whole-person care to vulnerable Medi-Cal members across San Diego County, CA. The Program Manager ensures high-quality service delivery, operational efficiency, and strict adherence to CalAIM billing and documentation standards.
Key Responsibilities
- Team Leadership & Supervision: Oversee, mentor, and evaluate a team of CalAIM CHWs conducting outreach, health navigation, group facilitation, and advocacy for high-risk populations.
- Program & Billing Compliance: Maintain full compliance with CalAIM guidelines, auditing CPT coding (98960, 98961, 98962, T1028), enforcing daily/period service unit limits, and ensuring clear boundaries regarding non-covered services.
- Quality & Documentation Assurance: Oversee dual-system documentation across the Partnership Health Portal and Pacific Health Group EHR, auditing member Plans of Care, six-month progress updates, and standardized assessments (SDOH 5-Q, PHQ-9/2, Hunger Vital Sign).
- Training & Workforce Development: Coordinate required onboarding and continuing education, including Motivational Interviewing, Mandated Reporting, and the Stanford University Advocacy Training for CHWs.
- Cross-Functional Collaboration: Partner with RNs, licensed clinical providers, and Humboldt County community organizations to streamline care coordination and interdisciplinary case management.
Required Qualifications
- Education: Bachelor's degree in Public Health, Social Work, Healthcare Administration, or a related field preferred.
- Experience: Minimum 3–5 years of experience in community health, Medi-Cal services, or social work, with at least 2 years in a supervisory or team lead capacity.
- Knowledge Base: Strong expertise in CalAIM policies, social determinants of health, chronic disease management, and local San Diego County resources.
- Licensure & Compliance: Valid California Driver's License (Class C) with an operable vehicle, clean MVR, and active auto insurance. CHW certification preferred.
Requirements
- Bachelor's degree in Public Health, Social Work, Healthcare Administration, or related field preferred
- Minimum 3–5 years of experience in community health, Medi-Cal services, or social work
- At least 2 years in a supervisory or team lead capacity
- Strong expertise in CalAIM policies
- Knowledge of social determinants of health
- Knowledge of chronic disease management
- Knowledge of local San Diego County resources
- Valid California Driver's License (Class C)
- Operable vehicle, clean MVR, and active auto insurance
- CHW certification preferred
Benefits
- Paid Time Off
- Holidays
- Volunteer time
- Bereavement
- Medical coverage
- FSAs
- Disability and EAP
- 401(k)
- Stipends
- Professional development
- Employee discounts
- Team events
- Growth opportunities
Company overview
Pacific Health Group is a leading healthcare management organization based in Carlsbad, California, dedicated to transforming lives through integrated whole-person care. Founded in 2023, the company specializes in providing comprehensive healthcare solutions with a focus on Medicaid populations across multiple states. Their innovative approach addresses the complete spectrum of health needs by combining exceptional managed medical care with comprehensive behavioral health services, vital social support programs, and essential housing navigation services. Pacific Health Group operates through locally managed health plans and strategic partnerships, emphasizing patient-centered care, cultural responsiveness, and community well-being. The organization's Enhanced Care Management programs coordinate medical, behavioral, and social services to meet complex patient needs, while their community support initiatives address upstream drivers of health outcomes. With a team of 51-200 dedicated professionals, Pacific Health Group serves thousands of members by breaking down barriers to healthcare access and creating pathways to wellness that extend beyond clinical settings. Their mission centers on elevating community health through compassionate, equitable, and individualized care that empowers people to achieve their highest potential for life.