Enhanced Care Management (ECM) Program Manager

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The Public Health Institute (PHI) is an independent, nonprofit organization dedicated to promoting health, well-being, and quality of life for people throughout California, across the nation and around the world. As one of the largest and most comprehensive public health organizations in the nation, we are at the forefront of research and innovations to improve the efficacy of public health statewide, nationally, and internationally.

Program Summary

The ACCA-AICP is a community-based, person-centered, care navigation intervention serving individuals with advanced illness and their caregivers in partnership with health, faith, and community organizations. Founded in the African American faith community, it is free of charge and respects the needs and wishes of the participant, whatever their culture and faith. Care Navigators are trained members of the community who walk alongside participants providing trusted referrals, resources, and specially designed tools to empower them to achieve their identified goals. The intervention is holistic in its approach by focusing on participant needs within our Five Cornerstones: spiritual, health (physical and emotional), social, advance care planning, and caregiving. The ACCA-AICP aligns with the ECM provider benefit through key elements of the AICP such as building trusted relationships, empowering participants through tools and training, and finding trusted resources in health, spiritual, advance care planning, social, and caregiving needs. Additional ECM elements such as clinician led care plan and health action plan development plus care coordination for individuals at risk of transitioning to higher levels of care such as nursing homes and those at risk for avoidable hospital or emergency department utilization, will be incorporated in the AICP+ model.

Position Summary

The Enhanced Care Management (ECM) Program Manager is a key role in the AC Care Alliance (ACCA). This individual will provide ECM Program expertise, guidance, and oversight as ACCA navigates the requirements and coordination of the California ECM program, developing an ACCA Advanced Illness Care Program (AICP)+ with medical care management and care coordination that meets ECM requirements.  Currently, the ACCA-AICP programs are in the Bay Area and Los Angeles with growth expected throughout CA.  Under management of the AC Care Alliance Executive Director, this role will be a subject matter expert in ECM and help traverse the requirements of the ECM benefit making sure that ACCA is successful as a certified provider of ECM benefits for program participants through the AICP+ program.

The Program Manager will directly assist the Executive Director in all responsibilities relating to the planning, implementation, ECM Care Navigator training and oversight, data gathering, monitoring, and evaluation of the overall AICP+ program. The primary purpose of this position is to provide program leadership and administration of the AICP+ program initially in Santa Clara and San Francisco counties, generate income opportunities for ACCA AICP+, oversee ECM Care Navigators and maintain fidelity to the model, analyze program activities and outcomes, and develop future funding opportunities.

This is a regular full time position that will work in California targeting Santa Clara and San Francisco regions as the first areas of AICP+ work. Candidates must reside in the San Francisco Bay Area in California or be able to relocate after hire.

The position is required to do local travel for up to 25% of the regular schedule. This position is currently remote and is expected to remain a remote position for the foreseeable future but will require regular in-person visits and occasional in-person meetings in Alameda, Santa Clara, and San Francisco counties, and the surrounding area.

Full salary range for this position: $80,043 to $118,302 per year. The typical hiring range for this position is from $80,043 (minimum) to $99,173 (midpoint), based on 100% FTE. The starting salary is determined based on the candidate’s knowledge, skills, experience, as well as budget availability.

Essential Duties & Responsibilities

AICP+ Program Refinement, Administration, and Operations

• Refine and implement the AICP+ Program, following program guidelines, policies, procedures, and engagement processes.
• Coordinate with the State and Network Medical Providers for access to referrals and reporting for evaluation and claims data.
• Through referral and/or outreach, identify individuals who can benefit from and may qualify for the AICP+ services.
• Assist with the outreach and hiring of ECM Care Navigators for the AICP+ program. Review applications, conduct phone screenings and interviews, documenting appropriate materials in the PHI hiring process.
• Assist with the training of the ECM care navigators on the AICP+ program, refining training materials and coordinating trainings over the specified time period.
• Determine AICP+ program eligibility for identified individuals from the health systems, community, or ACCA congregations.
• Facilitate care plan development meetings with the ECM clinician and appropriate members of the care team, helping to streamline the ECM clinician’s time.
• Meet regularly with ECM Care Navigators for case reviews, intervention monitoring, and to provide support, as needed.
• Where needed, facilitate access to services for participants, and provide tools and training to empower program participants across the 12-month AICP+ intervention.
• Manage Monitoring and Evaluation (M&E) for program performance, fidelity to the model, alignment with ECM benefit and social return on investment indicators (SRI).
• Work closely with ACCA to ensure proper report-back procedures are followed.
• Comply with all HIPAA confidentiality requirements.
• Adhere to all applicable health system compliance requirements including annual trainings, current immunizations, background check, drug testing, and annual flu vaccine and TB testing.

AICP+ Program Documentation in the Case Management Technology Solution, and Alignment with Claims Reporting

• Assist in the development or augmentation of a case management technology solution to document AICP+ work.
• Utilize the case management technology system to manage the AICP+ Program, ECM Care Navigator work, and ensure fidelity to the model.
• Provide regular updates to management on the technology system utilization. If a new or augmented system is needed, provide updates to management on the process to develop and implementation a new system.
• Ensure appropriate content from the case management technology solution is available for claims reporting.
• Provide training to ECM Care Navigators and others to use applicable case management technology solution(s) for program success.

ECM Relationship Management and Funding Opportunities

• Build and manage both new and current relationships with referring health care providers and organizations.
• As directed, utilize approved secure methods for communicating with health system patient’s primary care physician, which may involve accessing health system’s electronic medical records system.
• Directly support the Executive Director in fundraising and development activities for program.

Trainings and Supervision

• Prepare ECM Care Navigators to build and establish relationships with program participants.
• Prepare ECM Care Navigators to work with multidisciplinary care providers and community partners.
• Attend bi-monthly ACCA team meetings virtually, and in-person meetings when necessary.
• Assist with training for new Care Navigators and Care Team members, as requested.
• Collaborate w/ Program Leadership Team and health system partnership team to improve personal performance and AICP+ program process.

Travel for in-person visits and occasional in-person meetings in Alameda, Santa Clara, and San Francisco counties and the surrounding area, including some evenings and weekends.

Perform other duties as assigned.

Minimum Qualifications

• Five years of experience working closely with community health organizations.
• Bachelor’s degree in a related field, or substitute with four additional years of relevant experience.

Other Qualifications

• Direct experience in the development and implementation of an Enhanced Care Management program.
• Some graduate experience/training in Public Health, Public Health Nursing, Medical Social Work or related field from an accredited college or university preferred.
• At least three years’ experience working in the public health field.
• At least three years of supervisory or leadership experience in the field of public health or equivalent community practice setting.
• Experience in marketing, print journalism, public relations or a related field is preferred.
• Well-developed skills in organization/project management and personnel supervision.
• Working knowledge of budget policies and procedures.
• Ability to learn, interpret, and apply a wide variety of policies and procedures relating to and impacting the assigned programs.
• Ability to analyze data and make accurate projections using business mathematics and basic statistical techniques, as it relates to research and working with partners/media.
• Demonstrated ability to organize and plan work and projects, including handling multiple priorities.
• Ability to make independent decisions and exercise sound judgment.
• Ability to compile, write, and present reports.
• Demonstrated ability to establish and maintain effective working relationships within and outside the work group and serve as a liaison for assigned programs.
• Comprehensive knowledge of office-based computer programs.
• Ability to be highly self-motivated with strong verbal, research and writing skills.
• Ability to work a flexible schedule for in-person appointments with program participants, including some evenings and weekends.
• Ability to work with web technology systems, initiate and plan marketing/communications campaigns, and integrate efforts into electronic and social media platforms.
• Must have access to reliable transportation and the ability to commute for in-person visits and occasional in-person meetings in Alameda, Santa Clara, and San Francisco counties and the surrounding area.
• Must be able to pass background checks and drug screen required for this job.

FAIR LABOR STANDARDS ACT (FLSA) STATUS

This position is classified as exempt based on the job duties. However, based on the FTE, salary level of the employee, or federal/state/local laws, the employee may be classified as nonexempt.

PHI WORKFORCE MANDATORY COVID-19 VACCINATION POLICY

Per the PHI Workforce Mandatory COVID-19 Vaccination Policy, it is a condition of employment for all domestic based employees to be fully vaccinated for COVID-19, unless they are granted a reasonable accommodation under applicable law.

New hires need to provide proof of full vaccination prior to their start date or apply for an exemption/accommodation within three business days after their start date. Depending on the circumstances, new hires who do not comply with this Policy, or who cannot be reasonably accommodated, will either have their employment suspended or terminated. Candidates who are non-compliant will have their offers rescinded.

EEO Statement

The Public Health Institute is committed to a policy that provides equal employment opportunities to all employees and applicants for employment without regard to race, color, sex, religion, national origin, ancestry, age, marital status, pregnancy, medical condition including genetic characteristics, physical or mental disability, veteran status, gender identification and expression, sexual orientation, and to make all employment decisions so as to further this principle of equal employment opportunity. To this end, the PHI will not discriminate against any employee or applicant for employment because of race, color, sex, religion, national origin, ancestry, age, marital status, pregnancy, medical condition including genetic characteristics, physical or mental disability, veteran status, gender identification and expression, sexual orientation, and will take affirmative action to ensure that applicants are offered employment and employees are treated during employment without regard to these characteristics.

For further information regarding Equal Employment Opportunity, copy and paste the following URL into your web browser: http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf

ADA Statement:

The Public Health Institute is committed to providing access and reasonable accommodation in its services, programs, activities and employment for individuals with disabilities. To request disability accommodation in the application process, contact the Recruitment Team at least 48 hours in advance at Recruitment@phi.org.

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