Case Manager III — ECM/CS (Senior Lead Care Manager)

Case Manager III — ECM/CS (Senior Lead Care Manager) We are a company that focuses on treating the whole person. Our work is grounded in understanding the emotional, psychological, social, and practical factors that impact an individual’s well being. We believe effective care requires compassion, accountability, collaboration, and a commitment to meeting people where they are while supporting meaningful growth and long term stability. Our team works across departments to provide coordinated, ethical, and person centered services that prioritize dignity, respect, and quality care. At Simple Solutions Psychotherapy we believe, “It’s SIMPLE people just make it complicated.” The Case Manager III is the senior clinical and programmatic anchor of the ECM/CS team. This role carries a focused caseload of the highest-complexity members, functions as the program's lead clinical resource for risk stratification and crisis response, and provides formal supervision, training, and case consultation to Case Manager I and II staff. The Case Manager III also supports program operations, audit readiness, MCP relationship management, and quality improvement initiatives across the IEHP and Molina ECM/CS contracts. Minimum Qualifications Master of Social Work (MSW) required, OR Master's degree in Counseling, Marital and Family Therapy, Psychology, or Nursing (MSN) with five (5) or more years of progressive case management experience, of which at least two (2) must be in ECM, Health Homes, Whole Person Care, or equivalent Medi-Cal managed care care coordination. LCSW, LMFT, LPCC, or RN licensure strongly preferred; ASW, AMFT, or APCC with active supervision plan considered. Equivalent combinations of advanced education and senior-level case management experience will be considered. Prior supervisory or lead role experience required. Bilingual (English/Spanish) strongly preferred. Valid California driver's license, reliable transportation, and auto insurance required. LiveScan and TB clearance required. Caseload and Population Reduced direct caseload of approximately 15 to 25 highest-acuity members, with the remainder of capacity dedicated to supervision, program operations, and clinical consultation. Manages the most clinically complex and systemically involved members, including those with multi-system involvement (justice, child welfare, behavioral health, housing), high-risk perinatal cases, members with active suicidality or severe SMI requiring intensive coordination, and members with complex CS authorization and appeal needs. Carry the program's most complex Lead Care Manager assignments and serve as the clinical escalation point for the team. Provide formal supervision, case consultation, and clinical guidance to Case Manager I and II staff, including weekly individual supervision and group case conferencing. Lead onboarding and ongoing training for new ECM/CS staff, including DHCS ECM/CS Policy Guide orientation, MCP‑specific workflow training, and documentation standards. Conduct internal chart audits and program fidelity reviews to ensure compliance with IEHP, Molina, and DHCS requirements; partner with leadership on corrective action plans when needed. Serve as a point of contact for IEHP and Molina care management leadership, attending joint operating committee meetings and supporting contract performance reporting. Lead crisis response protocols, including coordination with mobile crisis, 988, San Bernardino County Department of Behavioral Health, and law enforcement diversion partners as appropriate. Support Program Manager in workflow design, policy and procedure development, hospital and SNF referral pipeline management, and Community Supports network expansion. Contribute to program evaluation, outcomes reporting, and quality improvement, including HEDIS‑aligned and ECM‑specific quality measures. Knowledge, Skills, and Abilities Expert‑level knowledge of CalAIM, the DHCS ECM and CS Policy Guides, Medi‑Cal managed care contracting, and MCP audit and reporting requirements. Demonstrated supervisory and team development skills. Advanced clinical assessment skills, including risk stratification, suicide risk assessment, and crisis intervention. Strong working knowledge of San Bernardino, Riverside, Los Angeles, and San Diego County service systems, including hospitals, SNFs, behavioral health, housing, and justice‑involved service networks. Skilled in policy and procedure development, audit response, and quality improvement methodology. The pay range for this role is: $75,000 – $92,000 annualized ($36.06 – $44.23 per hour equivalent), commensurate with licensure and experience. #J-18808-Ljbffr Simple Solutions Psychotherapy