Manager, Case Management (Special Populations)
CalOptima is a county organized health system that administers publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. With $3.2 billion in annual revenue, CalOptima serves nearly 800,000 members, delivering services through 14 health networks. For the past four years, CalOptima has been rated the top quality Medi-Cal plan in California, according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Ratings 2018–2019.
The position provides shared responsibility for the daily operations, activities and projects for the Case Management Department. This position will work under the general direction of the Director of Case Management and in partnership with the other department managers to provide performance management and development of the case management staff and projects associated with the department to ensure compliance with department policies and procedures along with the implementation of assigned projects. This position attends at various community meetings including but not limited to County of Orange Healthcare Agency (OCHCA) meetings, Federally Qualified Health Centers (FQHC), community organizations, and Health Networks. The position is responsible for monitoring reports and presenting to various internal and external committees, including the Homeless Response Initiative Steering Committee (HRISC). The incumbent has responsibility for development and management of the Homeless Response Team. Oversees staff who work directly with both the County of Orange and CalOptima’s contracted FQHC Clinical Field Team (CFT). The incumbent will be responsible for development and maintenance of relationships with Orange County Homeless Outreach and Engagement (HOE), County of Orange Healthcare Agency (OCHCA) Nurses, including the Comprehensive Health Assessment Team- Homeless, (CHAT-H), FQHC CFTs, and other entities.
Bachelor’s degree in public health, health care, or related field required. Master’s degree preferred.
Active and unrestricted RN license or LCSW license to practice in the State of California preferred.
Relevant experience working with vulnerable populations, including individuals impacted by homelessness, mental illness, or substance use required.
5 + years of managed care experience required.
5+ years of management level experience required.
CalOptima’s Manager, Case Management must work to:
Build and maintain positive relationships with multiple stakeholders.
Effectively communicate complex material, both verbally and in writing.
Develop creative/innovative approaches to challenges and opportunities.
Utilize and access computer programs – both Microsoft Office applications and job-specific applications
Think independently and disagree constructively with peers, community partners, and CalOptima leadership.
Develop and manage processes and work flows.
Effectively engage and lead a team of more than 20 employees or smaller teams of less than 5 toward a common goal or set of goals.
Maintain and ensure confidentiality of patient information.
Oversee scheduling of CalOptima staff and Clinical Field Teams.
CalOptima’s Manager, Case Management must have the ability to:
Case Management of vulnerable populations, including members experiencing homelessness.
Social Determinants of Health, Trauma Informed Care, Motivational Interviewing.
Principles and practices of managed health care.
Appropriate strategies to serve diverse groups.
Principles of effective supervision, team leadership, and staff engagement.
For a complete job description and to apply online, please go to www.caloptima.org. Questions can be directed to Debbie Neal, Senior Recruiter, 657-235-6891 or firstname.lastname@example.org.