Enhanced Care Management Lead Care Coordinator
Pacific Health Group
Summary
As a Lead Care Coordinator, you will personally guide members at every step, arranging all the services they need to thrive and building authentic, trusting relationships along the way.
Job description
Why This Role Matters - Holistic Impact and Compassionate Care
You will respond to real-life challenges such as housing, food insecurity, and mental health, ensuring that members' needs are addressed comprehensively. By forming strong, personal connections through frequent in-person visits, you will become a pivotal support system—someone members can rely on for comfort, guidance, and advocacy.
What This Role Looks Like (Day-to-Day Reality)
This is a high-impact, field-based role supporting members in the community.
- Manage a caseload of approximately 60–70 members
- Conduct 3–5 in-person visits per day (homes, shelters, community settings)
- Spend 60–70% of your time in the field
- Travel locally within hiring county (mileage reimbursed)
- Coordinate care across medical, behavioral health, and community services
- Document in real-time or by end of day using internal systems
What You'll Do
Care Coordination & Case Management
- Develop and manage individualized care plans
- Coordinate appointments, services, and follow-ups across providers
- Support transitions of care (hospital discharge, referrals, etc.)
Member Engagement & Advocacy
- Build trust through consistent, in-person engagement
- Advocate for timely access to care, services, and resources
- Support members navigating housing, food access, transportation, and behavioral health needs
Community Outreach & Engagement
- Represent Pacific Health Group in the community through outreach events, partnerships, and local initiatives
- Build and maintain relationships with community-based organizations, shelters, and local resource partners
- Identify opportunities to expand community presence and improve member access to services
Community Resource Navigation
- Connect members to local programs and services
- Build relationships with community-based organizations
- Identify gaps in resources and escalate when needed
Documentation & Compliance
- Complete timely and accurate documentation
- Maintain compliance with Medi-Cal, CalAIM, and ECM program requirements
Team Collaboration
- Partner with internal teams, providers, and community stakeholders
- Participate in case conferences and care coordination meetings
How Success Is Measured
- Consistent member engagement and visit completion
- Timely and accurate documentation
- Effective care coordination and follow-through
- Ability to manage caseload independently
- Positive collaboration with internal and external partners
- Ability to effectively communicate with internal and external stakeholders
Who Thrives in This Role
This role is a strong fit for someone who:
- Is comfortable working independently in the field
- Can manage a high caseload independently with minimal supervision
- Is resourceful, proactive, and solution-oriented
- Thrives in fast-paced, community-based environments
- Is passionate about supporting underserved populations
- Cares about their community and its people
- Independently navigate new software and company issued equipment
Requirements
- Must reside in hiring county
- 3–5 years in case management, social services, or healthcare (preferred)
- Experience with Medi-Cal, CalAIM, or Enhanced Care Management (preferred)
- Working experience of healthcare systems and community resources is a plus
- Excellent communication, organization, and time management skills
- Proficiency with documentation systems and technology
- Ability to effectively communicate both written and verbally
- Valid California Driver's License and active auto insurance meeting CA requirements
- Reliable personal vehicle for daily work use
- Successful completion of background check (including MVR)
- Must be able to travel up to 60-70% within the county to conduct in person visits
- Must successfully complete a Testlify skills assessment
- Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received
- Must have effective Time Management skills
- Must have internet speed of - 300+ mbps download and 25+mbps upload
- Must be proficient in technology, including documentation systems, case management platforms, and communication tools
- Preferred: Bilingual proficiency in Spanish
Benefits
- 401(k) Matching
- Medical, Dental & Vision
- Paid Time Off
- Paid Sick Time
- Paid Holidays
- Paid Volunteer Hours
- Flexible Spending Account
- Short-term Disability
- Long-term Disability
- AD&D Insurance
- Employee Assistance Program
- Mileage Reimbursement
- Monthly Stipend
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.