We are growing our Enhanced Care Management (ECM) program at Elica! ECM is a key part of CalAIM’s new statewide Medi-Cal benefit available to select “Populations of Focus" with complex needs and who are facing difficult life and health circumstances. This program is focused on breaking down the traditional walls of health care – extending beyond hospitals and health care settings into communities. ECM will address clinical and non-clinical needs of the highest-need enrollees through intensive coordination of health and health-related services and will meet beneficiaries wherever they are – on the street, in a shelter, in their doctor's office, or at home.

We are currently looking to add 5 new members to our team!

As a Care Coordinator (internally known at Elica as “Lead Care Manager” or LCM) you will be assigned as a beneficiaries’ point of contact for coordinating care and services among the physical, behavioral, dental, developmental, and social services delivery systems, making it easier for them to get the right care at the right time. The LCM will provide quality patient care via the development, implementation & evaluation of individual patient care plans. Is a liaison between the agencies, patients, and their family while following established professional standards of care, agency guidelines, policies and procedures.

BENEFITS:

Elica is proud to offer an exciting benefits package to qualifying full-time employees which can support your health, your family, and help you plan for the future.

• 403B retirement savings account with up to 4% employer matching contribution and 100% immediate vesting.
• Healthcare: Medical (Kaiser or Western Health Advantage Options), Dental, Vision - Individual and family plans available
• Company funded Health Reimbursement Arrangement (HRA) to help pay for out-of-pocket costs related to medical coverage
• FSA Plans: 2 options for Flexible Spending Accounts - Health Care FSA and Dependent Care FSA
• Company paid basic Life and AD&D Insurance. (supplemental life and AD&D options available)
• Optional Critical Illness, Accident, ID Theft Protection and Pet insurance potions
• Accrued paid time off and paid holidays.
• Employee Assistance Plan with five (5) free counseling visits, financial services, legal services, and a plethora of online resources.
• Tuition Reimbursement program and CME/CEU program.

Learn more about Elica’s services and mission at our website or check us out on Facebook.

WHAT ARE WE LOOKING FOR?

Job Summary

The Care Coordinator Team functions to support quality patient health care outcomes by the development, implementation & evaluation of individualized Health Assessment Plans (HAP) for Elica patients and MediCal patients on the Health Homes Program Targeted Engagement List (TEL) whose medical, behavioral, or social situations warrant additional layers of support. As part of the Care Team, the Health Homes Program (HHP) Care Coordinators will coordinate and manage our patient’s Medical and Behavioral Health needs through systematic Care Management services. The Care Coordinator will follow established professional standards of care, Elica Health Center (EHC) guidelines, policies, and procedures.

Care Coordinators assist patients to receive timely and effective care from Elica’s internal providers as well as referrals to community resources outside of Elica. The ultimate goal is well-coordinated care and optimal clinical outcomes. Care Coordinators work with patients individually and within a team environment to achieve these goals and because of their education & skills, are best able to educate patients as to the health benefits of coordinated care.

Care Coordination Functions

• Process Care Management and Behavioral Health referrals as ordered by EHC Provider;
• Process URGENT referrals within 1-2 business days;
• Process a minimum of 12 referrals per day;
• Complete appropriate Care Management/Behavioral Health Intake after acquiring patient consent;
• Develop/update Care Plan with patients and/or their supportive friends/family and facilitate patient engagement and follow-up;
• Document all patient encounter types in the medical chart;
• Supports the mental/physical/dental health care of patients on an assigned patient caseload (60 to 200);
• Closely coordinates care with the patient’s medical, behavioral, dental providers and, other health providers, as appropriate;
• Closely coordinates care with the Community Health Workers;
• Screens and assesses patients for common mental health and substance abuse disorders, as indicated;
• Provides patient education about common mental health and substance abuse disorders and the available treatment options, as directed by a healthcare provider;
• Facilitates in-clinic or outside referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment or behavioral activation) as clinically indicated;
• Facilitates referrals for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment);
• Facilitates the Transition of Care to an outside facility and/or from EHC Primary Care;
• Coordinates with the Community Health Worker (CHW) as needed;
• Attends weekly and/or daily Huddles or Case Consultation meetings to identify patient needs and update the patient’s Care Plan and the healthcare team;
• Maintain patient caseloads of 60-200.
• All other duties as assigned.

The successful candidate has:

• Bachelor’s degree in Social Work, Counseling, Psychology, Nursing or a related healthcare field (preferred);
• At least 1-year experience working within a Federally Qualified Health Center (FQHC) or outpatient clinic setting providing case management and/or care coordination services required;
• Experience working directly with patients in community clinics, mental health services and/or, community-based organizations assisting the homeless population;
• Experience in outreach and inter-agency referral services preferred;
• Previous experience with Electronic Medical Records (EMR);
• Knowledge of Microsoft Office and Google Suite;
• Effective professional writing skills;
• Possess effective interpersonal skills;
• Possess strong organizational skills;
• Ability to operate computer/laptop;
• Ability to exert physical effort maintaining and distributing files;
• Knowledge of basic nursing care and procedures, medical terminology;
• Strong understanding of HIPAA;
• Valid CA driver’s license and proof of personal auto insurance (on the vehicle driven during work hours) required;
• Current BLS and First Aid certification required.
• Knowledge of Sacramento and Yolo County Community Resources strongly preferred;
• Bilingual/Multilingual in Spanish, Farsi, Dari, Arabic, Russian, Hmong, American Sign Language (preferred).

Essential Skills/Abilities

• Possess strong organizational skills
• Reliable form of transportation
• Must demonstrate a high level of verbal, writing and listening skills.
• Ability to work in the field up to 6 hours per day, year round
• Ability to work appropriately and effectively within a variety of communities with varying populations, possessing strong interpersonal skills.
• Ability to distribute and maintain records and files
• Ability to operate computer, laptop, and/or cell phone

Additional Requirements

• Maintain daily Tracking Logs;
• Meet patients at their preferred Elica clinic location for face-to-face encounters;
• Work at various EHC clinic sites, as requested;
• Ability to work 8-hour daily work schedule between the hours of 8:00 AM to 6:00 PM;
• Ability to work Monday through Saturday.
• If selected for an employment opportunity with Elica Health Centers, external hires must provide proof of immunizations (Hepatitis B, MMR, Varicella & Tetanus), tuberculosis clearance, and proof of COVID-19 vaccination status* prior to their scheduled start date. Please be advised that this position is subject to criminal background investigation and drug screen.

Other Care Coordination Responsibilities to Support the Overall Practice:

• Provides appropriate community referrals/resources for patient needs;
• Provides crisis intervention and linkage with resources to patients;
• Works collaboratively on the patient grievance process with the Director of Social Services, Clinic Managers, Quality Director, Patient Advocate, and/or HHP Clinical Consultant;
• Develops and maintains collaborative relationships within the organization and amongst community partners.

Program Oriented Activities:

• Attends mandatory weekly Case Consultation meetings at various EHC sites;
• Attends mandatory staff meetings;
• Attends mandatory department trainings;
• Abides by and promotes agency administrative policies;
• Maintains continuing knowledge and practice of competence by participating in continuing education opportunities;
• Establishes relationships with community support organizations;
• Participates in agency performance evaluation at scheduled intervals throughout employment

• Elica Health Centers is a healthcare facility that adheres to the mandates issued by the California Department of Public Health including the recent orders regarding the COVID-19 vaccine. Medical and religious exemptions will be considered.

Physical Requirements and Work Environment

This job is conducted in the indoor environment of an ambulatory health care clinic setting. The ideal candidate must possess adequate visual acuity including the use of peripheral vision and depth perception to perform the job as described; must also possess adequate auditory and verbal acuity to perform described job functions. The job requires that the candidate possess the ability to walk and/or move about, sit and/or stand for long periods of time, reach, stoop, bend, and lift up to 20 lbs. Must be able to perform duties requiring repetitive hand movement and the use of a computer and computer monitor, as well as the use of a calculator. Must possess the ability to operate a fax machine, copier, and telephone, and at times, drive a personal car during work hours.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to walk and use hands. The employee is also required to stand; walk and reach with hands/arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment can range from quiet to moderately loud.

The employee may be in contact with individuals and families in crisis who may be ill, using substances and/or, not attentive to personal health. The employee may experience a number of unpleasant sensory demands associated with the client’s use of alcohol and drugs, and the lack of personal care. The employee may also be exposed to bio-hazardous materials (bodily fluids including blood and urine) and hazardous chemicals. The employee must be ready to respond quickly and effectively to many types of situations, including crisis situations and potentially hostile situations.

Compensation - Dependent Upon Experience

$25.00 - $32.50 an hour