ECM - ECM Supervisor (on-site)

The Enhanced Care Management (ECM) Supervisor is responsible for the day-to-day operations of the health center’s ECM program, a Medi-Cal managed care benefit under CalAIM that provides intensive, whole-person care coordination to members with complex health and social needs, and reports to the ECM Manager on program performance. This position directly supervises the ECM care team, manages caseload and outreach assignments, and serves as the primary operational contact for contracted Medi-Cal Managed Care Plans (MCPs).

The ECM Supervisor is accountable for member outreach and engagement, timely completion of comprehensive assessments and individualized care plans, care team coordination, and accurate documentation supporting MCP billing and reporting. This position ensures the program operates in compliance with DHCS ECM Policy Guide requirements, MCP contract terms, HRSA program requirements, HIPAA and 42 CFR Part 2, and supports UDS, HEDIS, and PCMH reporting.

This role requires strong supervisory, care coordination, organizational, and data management skills; the ability to work effectively with members experiencing homelessness, serious mental illness, substance use disorder, and other complex conditions; and a commitment to the mission, vision, and values of SDCHC.

Essential Duties and Responsibilities:

Primary Functions:

Supervision & Staff Development

1. Supervise the day-to-day work of Lead Care Managers, ECM Care Coordinators, and Community Health Workers, including assignment of caseloads, outreach lists, and field schedules.
2. Conduct regular individual supervision and team case conferences to review member progress, care plan barriers, high-risk situations, and closure decisions.
3. Recruit, onboard, train, and evaluate ECM staff in partnership with Human Resources; complete performance evaluations and initiate corrective action when warranted.
4. Monitor staff caseload capacity, productivity, and documentation timeliness, providing coaching and performance feedback as needed.
5. Ensure all ECM staff complete required training, including CalAIM ECM requirements, trauma-informed care, motivational interviewing, cultural humility, and safety protocols for field-based work.
6. Serve as the escalation point for complex, high-acuity, or crisis member situations, including safety concerns arising during field visits.

ECM Program Operations & Care Delivery

1. Oversee receipt and processing of MCP member assignment files, authorizations, and referrals, ensuring members are assigned to a Lead Care Manager within contractual timeframes.
2. Monitor outreach and engagement efforts, ensuring documented attempts meet MCP and DHCS standards before an unreachable determination is made.
3. Verify member eligibility for ECM Populations of Focus and confirm that enrollment, reassignment, and disenrollment activity is processed accurately and timely.
4. Ensure comprehensive assessments, individualized care plans, and care plan updates are completed within required timeframes and reflect member-identified goals.
5. Oversee delivery of the core ECM service components, including outreach and engagement, comprehensive assessment and care management, enhanced coordination of care, health promotion, comprehensive transitional care, member and family supports, and coordination of community and social supports.
6. Coordinate transitional care activities for members admitted to or discharged from hospitals, emergency departments, skilled nursing facilities, and institutional settings.
7. Facilitate referrals to Community Supports, behavioral health, substance use treatment, housing, food, transportation, and other social service resources.
8. Maintain a limited direct caseload as needed to support coverage, high-acuity members, and staff vacancies.

Care Coordination & Community Partnership

1. Serve as the primary operational liaison to contracted Medi-Cal Managed Care Plans, participating in joint operations meetings and responding to plan inquiries, data requests, and corrective action requests.
2. Coordinate closely with primary care, behavioral health, dental, pharmacy, and enabling services staff to ensure integrated, whole-person care.
3. Build and maintain working relationships with hospitals, county agencies, tribal organizations, housing providers, and community-based organizations serving the health center’s patient population.
4. Represent the ECM program in internal care team huddles, external partner meetings, and community collaboratives as assigned.

Documentation, Compliance & Reporting

1. Ensure all ECM services are documented in the Electronic Health Record (EHR) in accordance with DHCS, MCP, and health center documentation standards, including the elements required to support billing.
2. Audit member charts routinely for completeness, timeliness, and accuracy of assessments, care plans, contact notes, and consents; provide corrective feedback to staff.
3. Prepare and submit required MCP and DHCS reports, including enrollment, outreach, engagement, and encounter data, within contractual deadlines.
4. Monitor program performance data - engagement rates, assessment and care plan completion, transitional care follow-up, and caseload ratios - and report results to the Director and executive leadership.
5. Maintain compliance with HIPAA, 42 CFR Part 2, HRSA program requirements, and applicable federal, state, and county regulations governing care management and protected health information.
6. Maintain and operationalize ECM policies, procedures, workflows, and desk references established by the ECM Manager; support HRSA Operational Site Visits, Joint Commission surveys, MCP audits, and PCMH recognition activities.

1. Other duties as assigned.

Productivity & Performance Expectations:

1. Team caseload ratios: Maintained within contracted MCP and DHCS standards for each Population of Focus.
2. Outreach and engagement: Documented outreach attempts completed for 100% of newly assigned members within MCP-required timeframes.
3. Comprehensive assessments: Completed for at least 90% of engaged members within the required timeframe following enrollment.
4. Individualized care plans: Completed and updated for at least 90% of engaged members within required timeframes.
5. Transitional care follow-up: Post-discharge contact completed for at least 90% of applicable members within required timeframes.
6. Documentation timeliness: ECM encounters documented in the EHR within 24-48 hours of service delivery.
7. Chart audits: Minimum 5 member chart audits per assigned staff member per month.
8. Supervision: Individual supervision conducted with each direct report at least twice monthly; team case conference held at least monthly.
9. Reporting: MCP and internal program reports submitted by established deadlines with no late submissions.

Qualifications:

Minimum Qualifications:

1. Bachelor’s degree in social work, public health, nursing, psychology, health administration, or a related field; four additional years of directly related experience may substitute for the degree.
2. Minimum 3 years of case management, care coordination, or care management experience in a health care, behavioral health, or community-based setting.
3. Minimum 1 year of supervisory, lead, or program coordination experience.
4. Working knowledge of Medi-Cal, CalAIM Enhanced Care Management, and the ECM Populations of Focus.
5. Experience serving individuals with complex medical, behavioral health, substance use, or social needs, including individuals experiencing homelessness.
6. Demonstrated proficiency documenting in an Electronic Health Record or care management platform.
7. Valid California driver’s license, proof of insurance, and reliable transportation; position requires travel to community and field-based locations.

Preferred:

1. Experience with eClinicalWorks or a comparable care management platform.
2. Experience serving a multicultural population.
3. FQHC experience.

Special Conditions of Employment:

1. CPR/ BLS certification: Maintain a current Basic Life Support (BLS) certification issued by the American Heart Association (AHA), the American Red Cross, or an equivalent organization. Certification must include an in-person, hands‑on skills assessment. Online-only certifications are not accepted.
2. Annual background checks: Consent to annual background checks as a condition of continued employment, to ensure compliance with organizational standards and eligibility requirements.
3. For-Cause Drug Screening: Comply with drug screening requirements when initiated by the organization for cause, to support a safe, compliant, and drug‑free workplace.
4. Ongoing Compliance Requirements: Maintain up-to-date compliance with all required annual renewals, including professional licenses, certifications, physical examinations, TB testing, and mandatory regulatory trainings as assigned by the San Diego Community Health Center (SDCHC).
5. Driving Requirements: Maintain a valid California driver’s license, an acceptable driving record, and current automobile insurance as a condition of continued employment; consent to periodic DMV record checks.

Knowledge, Skills, and Abilities:

1. Excellent oral and written communication skills.
2. Excellent time management skills.
3. Excellent organizational skills and attention to detail.
4. Ability to maintain confidentiality and meticulous records.
5. Effective interpersonal skills.
6. Able to deal effectively with a diversity of individuals.
7. Ability to establish and maintain cooperative working relationships with all during the course of work.
8. Bilingual in Spanish/English a plus.
9. Must be reliable and extremely trustworthy.
10. Demonstrated proficiency in Microsoft Suite or related programs. Ability to learn other software systems used by the organization.
11. Demonstrated ability to lead, train, and motivate a multidisciplinary care team.
12. Working knowledge of trauma-informed care, motivational interviewing, harm reduction, and cultural humility principles.
13. Ability to interpret payer contract requirements and translate them into staff-level workflows.
14. Ability to analyze program data, identify trends, and implement corrective action.
15. Ability to exercise sound independent judgment in crisis and high‑risk member situations.

Physical and Mental Requirements:

1. Able to lift/move up to 25 pounds, move from place to place.
2. Able to sit at a desk and work on a computer for prolonged periods.
3. Able to stand, bend and reach for prolonged periods.
4. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress.
5. Ability to supervise, multitask, understand, and follow instructions.
6. Ability to proficiently read, write, speak, and understand English.
7. Able to travel to community, field, and partner locations, including private residences, shelters, hospitals, and encampments.
8. Able to work in unpredictable community environments and respond calmly to crisis situations.

Customer Service:

1. Actively supports, promotes, and works to fulfill the Mission, Vision, and core values of SDCHC.
2. Provides excellent internal and external customer service.
3. Demonstrates SDCHC’s Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.
4. Participates in on‑going customer service training.
5. In every action, seeks to promote SDCHC as a top service organization.

Quality Management:

1. Contribute to the success of the organization by participating in quality improvement activities.
2. Complies with all SDCHC policies and procedures and proactively participates in the implementation of new initiatives.
3. Participate and ensures continuous quality improvement process as directed by clinic leadership.

Safety:

1. Ensures regulatory compliance and adherence with policies and procedures related to safe work practices.
2. Participate in infection prevention through appropriate use of infection control measures during patient treatment and patient interactions.
3. Ensure compliance with regulatory requirements for maintaining physical spaces, equipment, and supplies.
4. Uses all appropriate equipment and/or tools to ensure workplace safety.
5. Immediately reports unsafe working conditions.

Privacy/Compliance:

1. Maintains privacy and security of all patients, employee, and volunteer information and access to such information. Such information is accessed on a need‑to‑know basis for business purposes only.
2. Complies with all regulations regarding corporate integrity and security obligations. Reports on unethical, fraudulent, or unlawful behavior or activity.
3. Upholds strict ethical standards.

Flexibility:

1. Available for all shifts and, when required, able to work evenings and weekends.

Disclaimer

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects management’s assignment of essential functions; it does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego Community Health Center, is an equal opportunity employer.

Acknowledgement

San Diego Community Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.