Enhanced Care Management Regional Manager | Inland Empire

Job Summary: The Enhanced Care Management (ECM) Regional Manager plays a pivotal role in guiding and supporting an assigned care team, ensuring the provision of high-quality care to members. Collaborating closely with senior leadership, the ECM Regional Manager empowers the team with tools, training, & resources necessary for success while upholding the standards of excellence in Care Management. The ECM  Regional Manager will manage and assign caseloads and provide day-to-day program coordination for the ECM Program with the support & full knowledge of the Director of ECM. The ECM Regional Manager duties encompass a wide range of responsibilities, from leadership and support to direct member engagement, all with the overarching goal of enhancing the quality of care & support provided to members. 

Essential Functions 

Administration  

• Build and maintain market growth strategy.  
• Meets regularly with assigned Director & health plan to identify areas for membership growth and outreach improvement.  
• Conduct financial analysis in collaboration with Finance team on assigned Managed Care Plan (MCP) to ensure positive profit and loss for the unit.  
• Act as key executive for assigned health plans.  
• Build and lead effective service delivery team measured by staff retention and MCP growth.  
• Establish and maintain effective customer relationships. 

Oversight 

• Ownership of quality metrics and develop improvement plans given MCP audit tools with expectation of superior audit results.  
• Coordinate team meetings, schedules for all members and ECM activities such as home visits, pending intakes, documentation, & joint retention visits.  
• Manage the outreach, engagement, enrollment, intake, assessments, and tracking of new enrollments for the ECM Program.  
• Assist with file compliance and audit preparation in coordination with Director.  
• Ensure all charts are in compliance with Department of Health Care Services (DHCS) standards at all times in both paper and electronic versions. Report all non-compliance to Director for corrective actions.  
• Data Collection and Reporting. 

Service and Support 

• Assign caseloads to team members based on Tier level. 

• Facilitate and link members to appropriate MCP resources.  
• Manage and conduct regular team meetings with staff to review progress towards goals, reassess and revise service plans using recovery-oriented service models.  
• Facilitate and lead consistent in-person team meetings. 
• Manage staff & ensure educational and employment goals are being met during scheduled meetings.  

Documentation & Data Collection 

• Work collaboratively with members of assigned ECM teams as needed to provide support and effectively perform their assigned job duties and contribute to the achievement of the program's goals and objectives of housing, income stability, healthcare goals, & assist with tier transitions as needed.  
•  Attend staff meetings, supervision and training as required.  
•  Attend community meetings as requested  
•  Other duties as assigned & required for program compliance and success. 

Position Requirements:   

Qualifications 

• Education: Bachelor’s degree in healthcare, social work, or related field or 4 years of management experience in a Case Management field; Master’s preferred. 
• Strong understanding of Care Management processes, healthcare regulations, & quality improvement initiatives 
• Prior Electronic Medical Record experience 
• Experience with Microsoft Office 
  

• Language: Proficiency in English (written and verbal). 
• License/Certification: Current and valid Driver’s License and auto insurance. 

Travel and Hybrid Work Schedule 

• Some travel is required to the assigned region and office. 
• 70% field based/30% remote.  
  

Benefits 

• Medical, Dental and Vision Insurance  
• We cover up to 100% of your premium and 50% of your dependent premium depending on the plan.  
• Flexible Spending Accounts, Health Savings Accounts & Dependent Care Accounts are also available. 
• Life, AD&D and Short-Term Disability Insurance funded 100% by Titanium Healthcare  
• Employee Assistance Program  
• 12 Paid Holidays, 3 weeks of all-inclusive PTO per year (accrual begins on the first day of employment) as well as a separate Paid Sick Time balance