Job Description

Impact Lives, Impact Community

Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 62 sites, over 227,000 patients, and over 417,000 visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.

Family Health Centers of San Diego (FHCSD) is looking for a Social Services Care Manager. The Social Services Care Manager will serve as the designated care manager for Members enrolled in the Enhanced Care Management (ECM) as part of the Department of Health Care Service (DHCS) broader initiative of the California Advancing and Innovating Medi-Cal (Cal AIM).

Responsibilities:

Responsible for providing direct and indirect Medical-Cal member services to support linkage and maintenance in care to ensure seamless care delivery for the Member and non-duplication of services.
Serve as the patient’s lead point of contact for any physical, mental health, and social support needs.
Operate as part of the multi-disciplinary care team, and is responsible for leading all aspects of the ECM and any Community Support (CS) services.
Work one-on-one with patients to help create, manage, and oversee all entities involved in the patient’s care through providing direct support to them.
Act as a liaison between patients, internal and external customers, including FHCSD service staff and other service providers, for the purpose of improving patient/client quality of care and flow.
Advocate on behalf of members, regularly collaborating with health care providers to determine needs and develop goals.
Complete all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with all grant funder and patients' insurance requirements.
Utilize required platforms to coordinate services and input data for reporting per MCO guidelines.
Provide a whole-person, interdisciplinary approach to care that addresses the clinical and non-clinical needs of high-need and/or high-acuity Medi-Cal Members enrolled in managed care.
Develop a comprehensive, individualized, person-centered care plan utilizing SMART goals, based on a Comprehensive Health Risk Assessment.
Determine appropriate services to meet the needs of patients, including services that address social determinants of health needs, including housing.
Ensure the care plan is reviewed, maintained, and updated under appropriate clinical oversight.
Address patient’s health status and/or gaps in care by identifying necessary clinical and non-clinical resources that may be needed.
Use motivational interviewing, trauma informed care, and harm-reduction approaches during patient interactions.
Coordinate with hospital staff on discharge plan.
Use discretion during all interactions to answer both routine and complicated questions, forwards issues to appropriate person.
Handle confidential and routine information. Attend meetings, training, and community events as required.
Coordinate and track external and internal department referrals to support the members’ overall care management plan. Actively participate in care management rounds.

Requirements:

1 - 3 years of experience with health education, case management, or working in the medical/health or other social services related field.
1 - 3 years of client-facing experience providing services to low-income populations with one or more of the following: complex chronic conditions, high utilizer of emergency room and tertiary health care services, severe mental illness, and/or homelessness preferred.
Bachelor’s degree in social work, public health, science, or other related degree required.
Master’s degree in social work, public health, science, or other related degree preferred.
Or equivalent combination of education and experience that provides the skills, knowledge and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
Must meet driving requirements

Rewards:

Job type: Regular Full Time
Competitive Salary with Excellent Benefits
Retirement Plan with Employer Match
Paid Time Off, Extended Sick Leave and Paid Holidays
Medical/Dental/Vision/FSA/Life Insurance
Employee Discounts and Wellness Programs

FHCSD was founded by community activists working towards a common goal: caring, affordable, high-quality medical care for all. We are proud to continue this mission today as we provide accessible services to over 210,000 patients across San Diego County. The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.

In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits or potential bonuses.

$24.00 - $29.97

If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here:

FHCSD Wellness – Employee Hub (gobenefits.net)

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