CalAIM Case Manager

Terms of Employment: Full-time, 40 hrs/wk.
Benefits: Medical (Kaiser), PTO/Vacation time, 403(b) savings plan, paid holidays, ongoing professional development.
Pay Range: $55,000 - $62,000/year, DOE
Expected Start: Early October 2024

POSITION SUMMARY

Under the direction of the Programs & Operations Manager and in collaboration with the rest of the case management team, the CalAIM Case Manager will employ the principles of traumainformed care to provide housing and medical navigation services for CalAIM (Medi-Cal) members in Yolo County. The Case Manager will create Enhanced Care Management (EMC) Plans, identify gaps in care and opportunities for Community Support (SC) services, and provide superior service with compassion and care in accordance with patient needs, company policies and procedures, and CalAIM regulations.

BACKGROUND

Since 2010, Mercy Coalition has provided unique forms of healing community to those impacted by homelessness, poverty, substance-use disorders, and mental-health trauma. Whether it’s providing emergency food and clothing, creating safe and healing space at our Recovery Cafe, or partnering with other service providers to create resource and opportunity pipelines, we strive to authentically see and embrace every individual we serve. We hold space for everyone and reverence for each of the beautiful, diverse stories we encounter. We view our workplace itself as an intentionally crafted space for restorative community. Historically, more than 80% of our staff members have had lived homelessness experience, and our workforce development program (the JAM Academy) creates 1-year paid internships for those in our priority population. Part of this present expansion is the introduction of regular CalAIM services offered.

ESSENTIAL DUTIES & RESPONSIBILITIES

  • Navigate Partnership Health of CA’s (PHC) electronic health record (EHR) system, PointClickCare (PCC).

  • Verify CalAIM member eligibility and update member information.

  • Professionally and compassionately engage and build rapport with all clients, including clients that might be in a mental health crisis or be struggling with active substance abuse.

  • Conduct outreach to current and prospective CalAIM members for enrollment in Enhanced Care Management (ECM) or Community Support (CS) services.

  • Identify barriers to success in housing or healthcare and set goals for long-term care planning.

  • Identify the need for treatment authorization requests (TAR) and compile documentation to support TARs to meet requirements for reimbursement.

  • Work closely with the Billing Coordinator to ensure timely and accurate submission of TARs via PCC.

  • Patient Advocacy: Provide transportation to and attend medical appointments (as needed), follow-up with providers, and help facilitate treatment based on PHC referral info and ECM planning.

  • Identify the need for escalation and provide community referrals for cases in which care needs exceed Mercy Coalition capacity.

  • Monthly electronic submission of shared PHC forms.

  • Mandated reporting: escalate to Management’s attention and/or report any observed or suspected abuse and/or neglect of children, disabled individuals, dependent adults and elder/ senior citizens. Other duties as assigned.

DESIRED SKILLS & QUALIFICATIONS

  • Ability to work with clients in an empathetic and respectful manner.

  • A basic knowledge of case management best practices and medical navigation is highly

    preferred.

  • Experience working in HMIS and/or PCC is preferred but not required.

  • Strong attention to detail and accuracy in data entry.

  • Experience working in a team environment.

  • A commitment to privacy and confidentiality in working with protected health

    information.

  • Experience working with Microsoft Office and ability to troubleshoot basic computer

    issues.

  • Ability to work time sensitive deadlines and accomplish tasks independently.

  • Good organizational and interpersonal skills.

  • Must have a valid driver’s license, registration and insurance.

  • High School Education/GED or equivalent.

The Mercy Coalition is an EEO Employer and Prohibits Discrimination/ Harassment of any kind.

Please submit a cover letter, resume or CV, and a Mercy Coalition job application to Executive Director, Don Bosley, don@wsmercycoalition.org. Position will remain open until filled.