Case Management HUB Manager-Hybrid

The Care Management HUB Manager is responsible for administrative and operational oversight of subcontracted care management services delivered under Enhanced Care Management (ECM) and/or California Integrated Care Management (CICM) programs. This position monitors subcontractor performance, supports implementation of program workflows, evaluates service delivery trends, and helps ensure that contracted services are delivered in alignment with DHCS requirements, managed care plan expectations, organizational standards, and applicable policies. This role serves as a primary program oversight contact for subcontractor performance, quality, compliance, workflow implementation, operational issue resolution, and escalation of performance concerns to program leadership. The position provides programmatic direction and technical guidance to subcontractors and subcontractor staff. Program Oversight and Subcontractor Performance Oversee day-to-day subcontractor performance against program, contractual, regulatory, and organizational requirements. Monitor subcontractor adherence to required workflows, documentation standards, outreach expectations, engagement benchmarks, assessment timelines, care planning requirements, service coordination activities, and follow-up expectations. Evaluate subcontractor performance trends and identify operational, quality, compliance, or service delivery risks that may affect program outcomes, contract performance, member experience, or health plan relationships. Provide programmatic guidance and technical assistance to subcontractor staff and subcontractor leadership regarding program expectations, workflow implementation, documentation requirements, performance gaps, and corrective action needs. Recommend operational changes, retraining, escalation, corrective action, or other performance improvement strategies to program leadership based on review of subcontractor performance data, documentation quality, service delivery trends, and program requirements. This position provides programmatic oversight and direction to subcontractors and subcontractor staff. This position is expected to evaluate operational risks, assessing subcontractor performance trends, interpreting program expectations, identifying quality or compliance concerns, and recommending appropriate action to program leadership. Quality Assurance, Compliance, and Contract Monitoring Review documentation, reports, and service delivery activity to assess accuracy, timeliness, quality, and compliance with DHCS, managed care plan, contract, and organizational requirements. Support internal and external audit preparation, chart review processes, quality monitoring activities, and corrective action follow-up. Identify patterns, gaps, barriers, and risks in subcontractor performance and collaborate with leadership to implement quality improvement strategies. Interpret program requirements and assist in translating contract, regulatory, and operational expectations into practical workflows, monitoring tools, and performance expectations. Maintain awareness of applicable program requirements and communicate changes, risks, or implementation needs to subcontractors and internal leadership. Evaluate complex operational issues, compare potential courses of action, and make recommendations to leadership regarding workflow changes, subcontractor performance interventions, escalation, or corrective action. Serve as a key point of contact for subcontractor-related operational questions, performance concerns, documentation issues, service delivery barriers, and program implementation needs. Resolve or escape issues involving subcontractor performance, member service delivery barriers, cross-functional coordination, documentation quality, and compliance concerns. Exercise discretion and judgment in prioritizing issues, assessing risk, determining appropriate escalation pathways, and recommending programmatic or operational solutions. Monitor implementation of approved performance improvement actions and communicate progress, barriers, and additional recommendations to leadership. Care Coordination Consultation and Complex Case Support Provide guidance and consultation to subcontractors on high-acuity, complex, or high-risk member situations, including cases involving homelessness, behavioral health needs, medical complexity, transitions of care, or system fragmentation. Support subcontractor staff in applying program expectations, care coordination best practices, engagement strategies, and escalation protocols for complex cases. Assist with operational problem-solving related to member engagement challenges, missed appointments, difficulty accessing services, or coordination barriers with external systems. Model and reinforce best practices in motivational interviewing, trauma-informed care, culturally responsive service delivery, and person-centered care coordination. Stakeholder and Cross-Functional Collaboration Serve as a liaison among subcontractors, internal program leadership, quality/compliance teams, managed care plans, healthcare providers, behavioral health partners, housing providers, and community-based organizations. Participate in interdisciplinary meetings, partner meetings, subcontractor performance discussions, and program operations meetings. Support communication with health plans and other stakeholders regarding referrals, service delivery expectations, performance issues, member needs, and program requirements. Collaborate with internal teams to support consistent implementation of program expectations, reporting requirements, and quality improvement activities. Data, Reporting, and Performance Monitoring Monitor caseloads, engagement activity, outreach performance, service delivery metrics, documentation timeliness, and other performance indicators. Use data and reporting tools to identify trends, gaps, risks, and opportunities for performance improvement. Prepare or contribute to performance summaries, quality updates, audit responses, and leadership reports related to subcontractor performance and program operations. Support accurate data tracking and reporting related to caseloads, engagement, outcomes, service delivery, and subcontractor performance. Qualifications Required Bachelor's degree in Social Work, Psychology, Public Health, Human Services, Sociology, Gerontology, Healthcare Administration, Business Administration, or a related field. Minimum of two (2) years of experience working in care coordination, case management, managed care, social services, healthcare operations, or community-based programs serving underserved populations with complex medical, behavioral health, housing instability, or social needs. At least two (2) years of program oversight, quality monitoring, vendor/subcontractor coordination, or operational management experience in care management, case management, social services, healthcare, or a related field. Experience working in community-based, field-oriented, hybrid, or multidisciplinary programs. Knowledge of Medi-Cal, managed care, safety-net healthcare systems, social service navigation, and care coordination programs. Ability to interpret program requirements, monitor performance expectations, identify quality or compliance concerns, and recommend operational improvements. Preferred Master's degree in a related field. Experience with ECM, CICM, Medicare/DSNP, Medi-Cal managed care, CalAIM, care transitions, or related care management programs. Experience overseeing subcontractor, vendor, provider network, or partner performance. Bilingual and bicultural skills reflective of the communities served. Skills and Competencies Program oversight, operational problem-solving, and performance monitoring skills. Ability to exercise independent judgment, evaluate competing priorities, and recommend appropriate action on matters affecting program quality, compliance, and operations. Strong understanding of quality assurance, documentation standards, contract expectations, and compliance monitoring. Ability to guide subcontractors and partner teams without overstating direct employment authority. Strong communication, facilitation, coaching, and stakeholder engagement skills. Ability to support teams working with high-acuity and complex member needs. Knowledge of community resources, housing systems, behavioral health services, healthcare navigation, and care coordination best practices. Excellent written and verbal communication skills, including the ability to prepare summaries, reports, and recommendations for leadership. Strong organizational skills and ability to manage competing priorities in a fast-paced program environment. Proficiency with electronic health records, care management platforms, data systems, reporting tools, and mobile work tools. Hybrid role with a combination of remote work, field-based activities, and in-person meetings, as required by program needs. May include occasional joint field visits, subcontractor meetings, community-based meetings, or partner meetings to support program operations and performance expectations. Reliable transportation may be required for field-based or in-person activities. Must be able to perform essential job functions, including lifting up to 5-10 pounds as needed. Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position. #J-18808-Ljbffr Valid8 Financial, Inc.