Medical Case Worker - $29.65/hr

Healthcare Staffing Professionals has an immediate need for a Medical Case Worker to support the Enhanced Care Management Program. Enhanced Care Management (ECM) is a Medi-Cal managed care benefit that addresses clinical and non-clinical needs of high-need individuals through the coordination of services and comprehensive care management. Childrens Medical Services (CMS) administers the California Children Services, the Medical Therapy Program (MTP), the Child Welfare Public Health Nursing Program, and the CMS Edelman Childrens Court Pediatric Program.

ECM-CMS program will serve this particularly vulnerable ECM population of focus (POFs): Children/Youth Enrolled in California Childrens Services (CCS) with Additional Needs Beyond the CCS Condition. DPHs ECM-CMS team has extensive experience and expertise in working with this population for intensive care management and care coordination. It is anticipated that some CCS clients are also in the Child Welfare System. These clients, when encountered will be included in the initial launch. After the initial successful program launch, ECM-CMS will consider growth to fully serve both POFs. Intensive care management will be provided based on comprehensive care plans that aim at addressing the need for overall care management for the multiple systems with which the child/youth and family interact

The positions will begin immediately upon acceptance and employment clearance and are initially funded through 8/31/26.

Pay Rate

$29.65/hr

Benefits

Paid Holidays, Paid Sick Time, PTO

Healthcare

Employer Fully Funded Healthcare (Anthem Blue Cross), Dental and Vision, Life Insurance from Initial Start Date.

Shifts: Full Time, M-F, 8am to 5pm in El Monte

Proposed Duties

• Medical Case Workers will provide direct ECM services to eligible members in the CCS population of focus. MSCs will be assigned based on their training and expertise with more experienced MSC being assigned to the most complex cases requiring care management across multiple domains (physical and behavioral health, social supports and family needs).
  
  

EXAMPLES OF DUTIES:

• As lead care managers, the medical case worker provide direct ECM services to eligible members. In this position, specific duties include but are not limited to:
  
  

Reaches out to potentially ECM-eligible clients to ascertain interest in ECM enrollment;

• Conducts initial and ongoing eligibility and health/social service needs assessments;
• Interviews and identifies clients and familys support, healthcare and behavioral needs;
• Utilizes environmental data gathered in relation to the medical or mental health problems to make recommendations concerning the provision of services that will ensure maximum benefits for each child/youth;
• Develops comprehensive, individualized, family-centered care plans;
• Provides primary ECM support to clients and their families;
• Monitors clients/families progress towards care plan goals and assists them where they encounter challenges;
• Helps families embrace healthy lifestyle choices and self-management skills-building;
• ECM-CMS Duty Statement - Medical Case Worker I (MCW I) Page 2 of 2
• Maintains contact with the families through electronic communications and personal visits;
• Keeps informed of community, mental health, and welfare resources and the variety of programs offered by each;
• Occasionally accompany families to service visits when of significant importance;
• Introduces and links families with social, supportive, and wrap-around services and benefits;
• Convenes team conferences, as necessary, with the clients/families care management providers and support network;
• Assists the patient/client and family members with environmental difficulties precipitated by the childs/youths condition, by arranging for childcare services, assisting to secure homemaker or attendant care services; works with CCS and MCP to develop resources for providing equipment, supplies, prosthetic devices, braces, and appliances; and
• Coordinates with the ECM LVNs to ensure that the clients are accessing appropriate/responsive health care