Leads enhanced care coordination for patients enrolled in CalAIM and transitions-of-care programs. Conducts outreach, assessments, discharge follow-up, medication adherence support, referrals, appointment coordination, and care-plan implementation. Collaborates with healthcare providers and community organizations, documents patient services, monitors program metrics, and advocates for patient access to medical and social resources.
Per Diem 30593
Ampla Health provides the individuals and communities we serve with high quality, comprehensive, community health care that is accessible to all and culturally and linguistically appropriate.
- Great Benefits including Medical, Dental, and Vision
- 4 weeks paid time off to start.
- 9 paid holidays
- 401k and profit sharing
- Full time, Monday to Friday
- Great work/home life balance
Ampla Health is seeking a compassionate and detail-oriented Lead Case Manager to coordinate care for high-risk patients through California’s CalAIM initiative. This role supports seamless transitions of care, engages eligible members, and helps connect them to medical and social services that improve outcomes.
Key Responsibilities:
- Conduct outreach and enroll eligible patients into CalAIM ECM program
- Coordinate post-hospital/ER care and follow-up appointments
- Perform assessments and develop individualized care plans
- Support medication adherence and health education
- Collaborate with care teams, hospitals, and community services
- Monitor quality metrics and maintain detailed patient records
- Advocate for patient needs and ensure care continuity
Qualifications:
- High school diploma required; Medical Assistant certification preferred
- Current CPR certification
- Valid CA driver’s license and insurance
- Excellent communication, problem-solving, and patient engagement skills
- Bilingual and/or experience working with diverse populations is a plus
Why Join Us?
Make a direct impact on patient health by helping individuals navigate care and access essential services. Be part of a collaborative, mission-driven team at the forefront of healthcare innovation.
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