ECM Program Manager

The ECM Program Manager is responsible for the leadership, operations, performance, and growth of Gracelight Community Health's Enhanced Care Management (ECM) program. This role oversees ECM services delivered in health centers and community settings, ensuring high-quality care coordination, regulatory compliance, timely documentation, and achievement of quality, productivity, financial, and patient outcome goals. The ECM Program Manager provides leadership to program staff and works collaboratively with clinical, operational, managed care, and community partners to strengthen care coordination, expand access to services, and continuously improve program performance.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

1. Directs day-to-day ECM program operations, including service delivery across health center, community, and mobile settings; establishes and maintains program workflows, policies, and procedures.
2. Supervises, coaches, and evaluates ECM staff; manages caseloads, productivity, and performance to meet program standards.
3. Ensures ECM services are delivered and documented in a timely, accurate, and compliant manner consistent with CalAIM, managed care contract, and organizational requirements.
4. Monitors program performance across enrollment, engagement, clinical quality, productivity, and financial metrics; identifies gaps and implements corrective action plans.
5. Collaborates with billing and finance to ensure accurate encounter documentation, claims submission, and reimbursement; resolves documentation and billing issues that affect program integrity.
6. Promotes interdisciplinary coordination among ECM staff, primary care, behavioral health, patient access, and quality teams to support continuity and integration of care.
7. Serves as the primary operational liaison with managed care plan partners; leads Gracelight's participation in plan audits, reporting, contract reviews, and performance improvement activities.
8. Develops and sustains referral relationships with community-based organizations, housing providers, shelters, hospitals, and social service agencies to support patient access and care continuity.
9. Identifies opportunities to improve, expand, or innovate program services; supports development and implementation of new initiatives as the program grows.
10. Prepares program reports, dashboards, and briefings for organizational leadership.
11. Supports regulatory reviews, contract compliance activities, and organizational audits as needed.
12. Maintains confidentiality of patient and organizational information in accordance with HIPAA and organizational policy.
13. Performs other duties as assigned.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

1. Bachelor’s degree in public health, Social Work, Healthcare Administration, Nursing, Business Administration, or related field preferred; equivalent combination of education and experience considered.
2. Minimum of 3–5 years of progressively responsible experience in care management, case management, population health, managed care, healthcare operations, or a related field.
3. Minimum of 2 years of supervisory or program management experience, including leading interdisciplinary teams and managing staff performance.
4. Bilingual English/Spanish highly preferred.
5. Experience in an FQHC, Medi-Cal managed care, or community-based healthcare setting preferred.
6. Experience with CalAIM Enhanced Care Management (ECM), Community Supports, or similar complex care management programs strongly preferred.
7. Knowledge of CalAIM requirements, Medi-Cal managed care, care coordination, healthcare operations, documentation standards, regulatory compliance, and reimbursement principles.
8. Experience using electronic health records (OCHIN Epic preferred) and proficiency with Microsoft Office applications, including Excel, Word, Outlook, and PowerPoint.
9. Experience analyzing program performance data and preparing reports and dashboards.
10. Proven ability to build collaborative relationships with managed care plans, community-based organizations, housing providers, and other stakeholders.
11. Strong leadership, organizational, analytical, project management, and communication skills with the ability to manage multiple priorities in a fast-paced environment.
12. Experience working with underserved populations and community-based service delivery models preferred.