CalAIM Outreach and Engagement Coordinator

Description:

Lutheran Social Services of Southern California began in December 1944 when a group of Lutheran congregations in San Diego came together to discuss how to better assist families in need. They began discussing how to form a Welfare Commission. Their vision expanded when they came together with another group of Lutheran congregations in Los Angeles having the very same conversation. Lutheran Social Services of Southern California was officially incorporated in 1946 as a 501(c)(3) non-profit social service agency. The mission has stayed true to its earliest beginnings, to be a servant to those in need. Today LSSSC serves thousands of individuals and families throughout Southern California with over 45 programs/services at 18 locations. We are part of the Lutheran Services in America (LSA) network and strive to serve those in need with dignity and respect.

Lutheran Social Services of Southern California’s Mission: Ignited by faith, we live out God’s love by embracing, equipping, and empowering vulnerable individuals, families, and communities toward self-sufficiency.

JOB SUMMARY:

Under the direction and supervision of the CalAIM Director, Sr. Program Manager or designated supervisor, the CalAIM Outreach and Engagement Coordinator (COEC) takes a leadership role in supporting CalAIM Community Supports (CS) and Enhanced Care Management (ECM) programs. This position coordinates outreach and engagement services by assisting staff in connecting with members for enrollment in CS and/or ECM services. The COEC also oversees resource allocation and communication of service accessibility to Medi-Cal beneficiaries and their families. This responsibility includes providing linkages with internal and external teams and partnering agencies to engage with and bridge members in populations of focus with appropriate services. Populations of focus include but are not limited to the individuals and families who are experiencing or at risk of homelessness/housing instability and/or are struggling with high and complex health related social needs (HRSN). The COEC plays a key role in referring members to CS and/or ECM services including referral loops for comprehensive needs assessment, planning, navigation, and coordination of care. This position supports CS and ECM staff in engaging with enrolled members to ensure a continuation of care and services; works in collaboration with internal CS and ECM service staff and leaders, as well as responds to the requests for services by external teams, partners, first responders, business owners, churches, and/or community residents. Excellent customer service skills and professional presentation and demeanor are essential as this position is the general public's first point of contact with LSSSC.

Essential Duties and Responsibilities:

• Provides effective outreach and engagement services to members from the Member Information Files/MIF and referral linkage processes.
• Searches and utilizes the Counties, Health Plans and Provider Database portals, i.e., HMIS, Coordinated Entry System/CES, Clinical Care Advance/CCA, and other associated portals for updated member contact information, SDOH relative data acquisition and support for service delivery strategy and related improvements.
• Participates in community events/supportive services events where those experiencing, at risk of homelessness or housing instability, high and complex health related social needs (HRSN) may attend and provide outreach, engagement, and linkage to Community Supports (CS) and/or Enhanced Care Management (ECM) services.
• Performs intake assessment screenings and enrollment of members for CS and/or ECM services as needed, and works in collaboration with intake specialist teams, case managers/housing navigators and lead care managers/care coordinator teams to offer members the appropriate services.
• Provides referrals and information regarding social service and safety net healthcare service providers to those in need.
• Communicates with administrative staff and program managers regarding prospective clients as each self-referral is made.
• Cultivates relationships with CS and/or ECM providers who are seeking CS and/or ECM providers for member referrals.
• Builds relationships with staff working in homeless shelters and other community settings to identify and assist members with access linkages to CS and/or ECM services.
• Identifies and collaborates with other social services and safety-net healthcare service agencies to provide multiple options for members.
• Participates in the local county or countywide Continuum of Care and/or safety net health and social network meetings, other CalAIM program activities as needed, i.e., LSSSC Mobile Wellness Unit outreach and partnership engagement events.
• Supports CS housing programs as needed by recruiting, engaging, and liaising with landlords, property managers, etc.
• Assists ECM program as needed by recruiting, engaging, and liaising with safety net health and social service providers, local community clinics, hospitals, community- and faith-based organizations/CBO and FBO networks, and community centers.
• Collects monthly data associated with SDOH demographics and geographics on number of CS and/or ECM service recipients, i.e., CS-housed members, members who have obtained a voucher, and members who have been aided with move-in costs, to present to supervisors, team, corporate and community partners, as well as ECM-HRSN-served members in planned care and support management progress.
• Creates a standard network of resources by networking with case managers/housing navigators, lead care managers/care coordinators, and community partners.
• Disseminates the approved practice manuals and resources to support CS and/or ECM case management teams.
• Organizes visits to new partner sites with the CS and/or ECM case management teams to grow familiarity with resources available and promote partnerships.
• Maintains confidential and accurate data for all the members served. Recordkeeping tools include but are not limited to intake documents, HMIS and case notes, CES, CCA portals.
• Complies with requirements to keep documents secure and up to date while following all program policies and HIPAA rules for compliance.
• Notifies Program Manager/Sr. Program Manager of all plan members, staff, or Agency issues, program issues/concerns.
• Facilitates De-Escalation and Crisis Intervention with plan members.
• Attends job training and performs other duties as assigned by the Director or assigned Sr. Program Manager.

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations. Uses reason even when dealing with emotional topics.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
• Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
• Written Communication - Writes clearly and informatively; edits work for spelling and grammar; Varies writing style to meet needs; Able to read and interpret written information.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed; Recognizes accomplishments of other team members.
• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
• Assessments and Care Coordination – Demonstrates ability to follow through with Care Plan to fulfill plan members needs and maintain care plan to address identified needs and show outcomes.
• Knowledge of Community Resources – Demonstrates knowledge of community resources and ability to optimize comprehensive resource lists to serve plan members effectively.
• Ethics - Works with integrity and ethically; upholds organizational values.
• Innovation - Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; contributes innovative approaches and ideas; contributes ideas and information in a manner that gets others' attention.
• Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports, explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.

Requirements:

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience: An associate degree is required with a minimum of 3-4 years of relevant work experiences, or B.S. or B.A. degree and at least 2 years of experience in Social Work, Mental Health, Healthcare, Human Services, clinical settings, or equivalent experiences preferred.

Language Ability: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals.

Math Ability: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, percent and to draw and interpret bar graphs.

Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Computer Skills:

To perform this job successfully, an individual must have a good working knowledge of Word processing software and Excel spreadsheet software.

Certificates and Licenses:

No certifications needed.

Supervisory Responsibilities:

This job has no supervisory responsibilities.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Physical Demands:

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee may be required to spend a significant amount of time driving. The employee must have the ability to meet this requirement as well as drive in inclement weather as described in LSS policy.

Specific vision abilities required by this job include close vision. While performing the duties of this job, the employee is frequently required to stand, walk; sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear.