Case Manager II

Overview

Job Summary:

The Case Manager II is an experienced ECM Lead Care Manager who carries a moderate-to-high acuity caseload,

serves as the primary CalAIM Lead Care Manager for assigned members, and provides peer guidance to Case

Manager I staff. This role independently manages complex care coordination across the full ECM Population of

Focus categories, leads interdisciplinary care team meetings, and ensures compliance with IEHP, Molina, and

DHCS programmatic and documentation standards.

Caseload of approximately 30 to 50 moderate-to-high acuity ECM members. Serves as Lead Care Manager for

members with complex co-occurring conditions, including individuals experiencing homelessness with serious

mental illness, justice-involved adults and transition-age youth re-entering the community, individuals with high

utilization patterns (frequent ED or inpatient use), pregnant and postpartum individuals with complex needs, and

members transitioning from incarceration, hospitals, or institutions. Authorizes and coordinates the full menu of

Community Supports.

*Job summary is subject to change*

 

Accountabilities:

• Gain a thorough understanding of Simple Solutions Psychotherapy’s mission, values, and Patient Promise.

• Gain a thorough understanding of the DHCS ECM Policy Guide, CS Policy Guide, and IEHP/Molina Lead Care

Manager requirements.

*Accountabilities are subject to change*

Supervisory Responsibilities:

• None (provides informal peer guidance and case consultation to Case Manager I staff; not a formal

supervisory reporting relationship).

Duties/Responsibilities:

• Serve as Lead Care Manager under CalAIM ECM, with primary accountability for the member’s Care Plan,

ICT coordination, and care continuity.

• Conduct comprehensive biopsychosocial assessments, risk stratification, and Care Plan development and

revision in alignment with DHCS ECM Policy Guide standards.

• Lead and facilitate interdisciplinary care team meetings, including representatives from primary care,

behavioral health, CS providers, MCP care managers, and community partners.

• Coordinate complex transitions of care from hospitals, SNFs, jails, and residential treatment, including 30-

day post-discharge follow-up requirements.

• Authorize, refer to, and monitor Community Supports utilization, ensuring appropriate documentation and

Managed Care Plan authorization workflows.

• Provide informal mentoring and case consultation to Case Manager I staff.

• Participate in quality improvement, case review, and program fidelity monitoring activities.• Ensure all documentation meets MCP audit standards, encounter data submission requirements, and

contractual deliverables for IEHP and Molina.

*Duties/Responsibilities are subject to change*

Required Skills/Abilities:

• Working knowledge of the DHCS ECM Policy Guide, CS Policy Guide, MCP contracts, and Medi-Cal

billing/encounter requirements.

• Demonstrated ability to manage complex caseloads independently.

• Strong clinical judgment in risk assessment, crisis response, and care plan development.

• Familiarity with motivational interviewing, harm reduction, trauma-informed care, and culturally responsive

practice.

• Proficient in EHR documentation, care coordination platforms (e.g., MCP portals), and outcome tracking.

*Required Skills/Abilities are subject to change*

 

Education and Experience:

• Master of Social Work (MSW) preferred, OR Bachelor’s degree in Social Work, Psychology, Nursing, Public

Health, or related field with three (3) or more years of progressive case management experience in Medi-

Cal managed care, ECM, Community Supports, Health Homes, Whole Person Care, behavioral health,

hospital case management, or community-based care coordination.

• Equivalent combinations of education and directly relevant case management experience will be

considered.

• Prior experience as a Lead Care Manager under CalAIM ECM is strongly preferred.

• Bilingual (English/Spanish) preferred.

• ASW, AMFT, or APCC registration a plus.

• Valid California driver’s license, reliable transportation, and auto insurance required.

• LiveScan and TB clearance required.

 

Physical Requirements:

• Prolonged periods sitting at a desk and working on a computer.

• Must be able to lift up to 15 pounds at times.

• Traveling to members’ homes, hospitals, SNFs, and community locations to conduct assessments and lead

care coordination.

• Traveling to other locations for interdisciplinary care team meetings and community outreach.

*Physical Requirements are subject to change*