Enhanced Care Management Program Manager

This is a fully remote position, open to applicants in Nevada.

📋 Description

• Oversee Pacific Health Group’s Enhanced Care Management program aimed at vulnerable and high-need populations.

• Supervise, mentor, and guide Lead Care Managers across various counties.

• Conduct weekly one-on-one meetings, review caseloads, provide coaching, and lead weekly team discussions.

• Regularly meet with staff in person.

• Set performance benchmarks and metrics.

• Implement quality assurance protocols and standardized workflows.

• Monitor staff performance while identifying trends and areas for improvement through data analysis.

• Ensure that members receive in-person visits and high-quality, person-centered care.

• Oversee documentation and assist with complex cases.

• Enhance member engagement and satisfaction.

• Act as a liaison with hospitals, providers, and community organizations.

• Work collaboratively with data and compliance teams to track outcomes and uphold regulatory standards.

• Strengthen care-transition partnerships to minimize hospital readmissions.

• Develop and manage program budgets, allocate resources, and monitor expenditures.

• Adjust staffing and resources in accordance with member needs and program priorities.

• Identify and pilot initiatives such as telehealth services.

• Stay updated on best practices and incorporate improvements.

• Lead operational huddles and bi-weekly case conferences.

• Create mentorship programs and regional training for staff.

• Prepare quarterly performance reports and maintain relationships with stakeholders.

• Travel frequently to county locations in California and support occasional evening or weekend activities.

⛳️ Requirements

• Bachelor’s or Master’s degree in Healthcare Administration, Public Health, Nursing, or a related field.

• Over 5 years of experience in healthcare management, including at least 3 years in care or case management.

• At least 2 years of experience managing Enhanced Care Management or intensive care management programs.

• Knowledge of care management principles and healthcare delivery systems.

• Familiarity with Medicaid/Medicare programs and ECM program requirements.

• Strong analytical skills with experience in data-driven program evaluation.

• Excellent leadership and communication abilities.

• Capability to manage multiple priorities in a fast-paced environment.

• Commitment to person-centered care and health equity.

• Must reside within the hiring state.

• Valid Driver's License and active auto insurance that meets state requirements.

• A reliable personal vehicle for daily work use.

• Successful completion of a background check, including MVR.

• Willingness to travel up to 60-70% within the county for in-person visits.

• Must successfully complete a Testlify skills assessment.

• Must have a reliable working laptop for the first 21 days of employment until a company-issued laptop is provided.

• Effective time management skills are essential.

• Internet speed of at least 300 Mbps download and 25 Mbps upload.

• Proficient in technology, including documentation systems, case management platforms, and communication tools.

• Availability to work occasional evenings and weekends as required.

🏝️ Benefits

• 160 hours of Paid Time Off (PTO).

• 12 paid holidays annually, including your birthday and one floating holiday after one year of employment.

• 4 paid volunteer hours each month.

• Bereavement leave, including for pets.

• 90% employer-paid Employee-Only medical benefits.

• FSA | Dependent Care Account.

• 401(k) plan with company match.

• Monthly stipend.

• Short-term and long-term disability coverage | Accidental Death & Dismemberment (AD&D).

• Employee Assistance Program (EAP).

• Employee discounts through Great Work Perks and Perks at Work.

• Quarterly in-person events.

• Fully remote work options.

• Opportunities for professional development and internal advancement.

• Personal equipment stipend for a reliable working laptop during the first 21 days of employment.