Onecare Jobs (NOW HIRING)

Join Us in this Amazing Opportunity

The Team You’ll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

More About the Opportunity

We are hoping you will join us as a Care Manager (OneCare) and help shape the future of healthcare where you’ll be an integral part of our Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Community Worker.

• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

Case Management is an advanced specialty collaborative practice, responsible for providing case management services for CalOptima Health OneCare members. The Care Manager for One Care will facilitate communication and coordination among all participants of the health care team and the OneCare member to ensure the services provided promote quality and cost-effective outcomes. You will be responsible for providing intensive case management, which includes assessment, care planning, implementation, coordination, monitoring and evaluation of the member’s needs. You will meet with members in-person in the setting of their choosing aligning with member preference. Together, we are building a stronger, more equitable health system.

Your Contributions To the Team:

• 85% - Care Management
  • Assesses member needs using a standardized health needs assessment or health risk assessment with member.
  • Performs comprehensive, disease specific, clinical assessments of all identified cases, at minimum, annually which includes, but is not limited to, assessment of:
    • Member’s physical, functional, social and psychological status
    • Member’s cultural and linguistic needs
    • Caregiver resources and available benefits
  • Performs post-discharge assessment to identify member’s post-hospital or post-ED discharge needs including but not limited to:
    • Member’s physical, functional, social and psychological status
    • Member’s cultural and linguistic needs
    • Caregiver resources and available benefits
    • Follow-up provider care and ensuring scheduled appointments
    • Durable medical equipment and supplies
    • Community resources
  • Develops and implements a member’s specific care plan which includes prioritized SMART goals.
  • Care plan will be continuously reviewed, modified and updated to reflect the member’s needs, at minimum, annually or upon change in condition.
  • Schedules follow-ups to assess progress towards goals and identifies barriers to meeting goals.
  • Provides regular outreach to assigned members along with members from a worklist and evaluates quality of service given to members according to department contact standards.
  • Coordinates care and services with members, members’ family members/representatives and other providers, as appropriate, including Community Supports and LTSS.
  • Conducts face-to-face meetings at settings outside of CalOptima Health’s locations such as in hospitals, skilled nursing facilities, long-term acute care hospitals, recuperative care and in member’s home settings with members, members’ family members/representatives and other providers, as appropriate.
  • Communicates with Member’s physicians, specialists, community agencies and vendors to ensure coordination of services.
  • Facilitates referrals to behavioral health/substance use disorder services and identifies and makes referrals to Long-Term Support Services (LTSS) department, Community Supports and community resources.
  • Facilitates and participates in Interdisciplinary Care Team meetings, as applicable.
  • Collaborates with interdepartmental staff in case resolution as needed.
  • Identifies cases needing manager, director or medical director review or input, routes accordingly and closes cases according to procedures and guidelines in a timely manner.
  • Prepares and maintains appropriate documentation of patient care and progress within the documentation platform or care plan as appropriate.
  • Advocates in the member’s best interest for necessary funding, treatment alternatives, timelines and coordination of care and frequent evaluations of progress and goals.
• 10% - Administrative Support
  • Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Follows CalOptima Health’s protocol for documenting all case interventions.
  • Ensures reporting of productivity metrics to supervisor.
• 5% - Other
  • Completes other projects and duties as assigned.

Do You Have What the Role Requires?

• Master’s degree in social work, psychology, gerontology, public health, social science, or related field PLUS 3 years of clinical experience and/or managed care experience required.
• Valid driver’s license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 51% of the time or more.

You’ll Stand Out More If You Possess the Following:

• Licensed Vocational Nurse, Licensed Marriage and Family Therapist or Licensed Clinical Social Worker.
• Experience with behavioral health or substance use case management.
• Certified Case Manager (CCM) certificate.
• Bilingual in English and in one of CalOptima Health\'s defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).

What the Regulatory Agencies Need You to Possess?

• n/a

Your Knowledge & Abilities to Bring to this Role:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Your Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Ways We Are Here For You

• You’ll enjoy competitive compensation for this role.
• Our current hiring range is: Pay Grade:310 - $72,096 - $115,353 ($34.66 - $55.4582).
• The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
• This position is approved for Community Worker
• A comprehensive benefits package
• CalPERS pension program and additional retirement packages.
• Additional benefits and perks including:
• A generous PTO program
• A quality work life balance
• Various wellness programs
• Tuition Reimbursement
• Professional development opportunities
• Career development opportunities
• Flexible scheduling
• And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.

Our Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

Why Join Us?

We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

What\'s Your Next Step?

Despite the above, the posting process and timelines here must be kept confidential. The employer reserves the right to update the posting and requirements at any time. Please note that recruitment timelines may change.

Our Commitment to You

Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

We will not discuss internal applicants by name. You will be contacted if you are a match for this role. You will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.

We will not share your information with anyone outside CalOptima Health. We will keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and your emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.