Status: Full-Time, Non-Exempt
Pay: $23.00-$24.00/hour
Schedule: Monday - Friday 8:30 a.m. - 5:00 p.m.

Mission Statement: "To be a leader in ending homelessness by providing a unique system of dignified housing opportunities, programs, and supportive services."

Benefits Offered:

• 100% employer-paid medical insurance at base tier
• Voluntary dental and vision coverage
• Paid Time Off (PTO)
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP)
• 403(b) retirement plan with up to 3% employer matching
• Paid on-the-job training and orientation
• Mileage reimbursement
• Employee referral program
• Opportunities for professional growth and advancement

Job Summary: The Enhanced Care Management (ECM) Lead Care Manager is responsible for coordinating medical and non-medical supportive services to meet the needs of each member. These services include physical, behavioral, dental, developmental, oral health, long-term services and supports (LTSS), Specialty Mental Health Services, Drug Medi-Cal/Drug Medi-Cal Organized Delivery System programs, Community Supports, and other resources addressing social determinants of health (SDOH)—regardless of the care setting. The ECM Lead Care Manager collaborates closely with the CalAIM Community Supports Program to deliver team-based, patient-centered care for clients experiencing or at risk of homelessness.

Essential Duties and Responsibilities:
Client/Service Delivery

• Manage a caseload of approximately 17–25 members, meeting regularly to complete Health Needs Assessments and develop individualized Care Plans with measurable short- and long-term goals
• Conduct outreach, engage, and enroll eligible members in ECM services, addressing barriers to access and care
• Provide services at locations that are accessible and convenient for the member, including their residence or places where they seek care, in alignment with CalOptima Health guidelines
• Assist members with care engagement, including medication reconciliation, scheduling and reminding about appointments, coordinating transportation, and attending critical medical visits when needed
• Advocate on behalf of members with healthcare providers and assist with hospital discharge planning
• Coordinate care with hospitals, behavioral health providers, specialists, dental providers, LTSS entities, and Community Supports partners
• Utilize trauma-informed care and motivational interviewing techniques to engage members
• Monitor treatment adherence, including medication compliance
• Provide health education, self-management support, and care navigation to empower members
• Regularly communicate member updates, needs, and concerns to the multidisciplinary care team to enhance care outcomes
• Perform additional duties as assigned or modified to support program goals

Team/Staff Relations

• Collaborate as a team member within Mercy House, supporting the organization’s mission and core values
• Participate in internal and external meetings and contribute to planning resident-focused programs
• Maintain adaptability in a fast-paced, team-based environment while demonstrating empathy, reliability, and effective communication with diverse populations

Administration

• Maintain thorough and timely documentation for all assigned members, including Health Needs Assessments and Care Plans
• Support data collection and reporting requirements
• Ensure timely completion of all assigned tasks and meet documentation deadlines
• Utilize technology and software tools proficiently (e.g., Microsoft Word, Outlook, Excel, PowerPoint), along with any position-specific systems
• Respond to emails and phone inquiries promptly and manage workload independently while prioritizing responsibilities

Knowledge of:

• Confidentiality standards and ethical considerations in case management
• Best practices for clinical documentation and adherence to program guidelines

Requirements:
Education and Experience

• Bachelor’s Degree in Social Work (or related field) with experience working in recovery, mental health, and co-occurring disorders are preferred
• Candidates without a BA/BS degree but with at least 2 years of relevant experience working with individuals experiencing long-term homelessness, low-income backgrounds, and diverse populations, and who possess a working knowledge of mental health and substance use issues, are encouraged to apply
• Preferred skills include outreach and engagement, care planning, care coordination, health promotion, transitional care support, member and family education, and linkage to social services
• A minimum of 1 year of experience in care coordination or case management is strongly preferred, particularly with the following populations:
  • Individuals or families experiencing homelessness
  • High utilizers of hospital or emergency services
  • Individuals with serious mental illness (SMI) and/or substance use disorders (SUD)
  • Adults transitioning from nursing facilities to community-based settings
  • Adults with intellectual or developmental disabilities
• Experience with HMIS Data Entry/CalOptima Health is highly preferred
• Preferred experience with Housing First and harm reduction models, Motivational Interviewing, Patient-Centered and Trauma-Informed Care, Crisis Intervention and Prevention strategies
• Experience assisting individuals and families with complex needs (acute mental illness and substance use) to access healthcare and community resources is highly preferred
• Computer literacy and proficiency in Microsoft Office programs (Word, Excel, Outlook, PowerPoint) are required

General

• A valid CA driver’s license, proof of insurance and a reliable vehicle is required. Comfortable with utilizing your own vehicle to conduct home visits, visiting clients at shelters, meeting clients out in the community etc.
• Ability to work effectively with a diverse population; plan, organize and prioritize duties; crisis intervention as needed; clearly communicate information and instructions verbally and in written form; maintain a positive, professional, and safe environment while on duty; and establish and maintain effective working relationships with others
• Dependability, responsibility, and the ability to communicate effectively and respectfully are mandatory skills
• Fluency in Spanish is of significant value

Physical Requirements

• Ability to lift items weighing up to 50 pounds
• Prolonged periods of sitting at a desk and working on a computer

Mercy House is an E-Verify employer. E-Verify is an Internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States. Please click on the following links for more information.

E-Verify Participation Poster: English & Spanish (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
E-Verify Right to Work Poster: English & Spanish (https://www.e-verify.gov/sites/default/files/everify/posters/IER_RightToWorkPoster%20Eng_Es.pdf)

Mercy House must reserve the right to modify, supplement, rescind, or revise all job descriptions to meet the overall needs of Mercy House except as to any language that establishes that the employment relationship is at the will of either the staff member or Mercy House.