| May 2023
T.H.E. CLINIC, INC.
JOB DESCRIPTION
POSITION: Enhanced Care Case Manager
DEPARTMENT: Medical Unit
STATUS: Full-Time, Non-Exempt
POSITION SUMMARY:
Under the direct supervision of the Enhanced Care Management (ECM) Director the Enhanced Care Case
Manager is the Lead Care Manager (LCM) for the Enhanced Care Management Program and is responsible for
coordinating and implementing organization-wide Enhanced Care Management. Utilizing strong organizational
and communication skills, the LCM ensures the delivery of safe and efficient care, working cooperatively in an
interdisciplinary team to provide support for members experiencing homelessness, serious mental
illness/substance use disorder, and/or high medical needs. They oversee and implement provision of the ECM
services; and identification and achievement of Care Plan goals and objectives with the member that meet
their self-identified strengths and health care and psychosocial needs.
Essential Duties and Responsibilities:
• Engages eligible ECM members
• Offers services where the ECM member lives, seeks care, or finds most easily accessible and within
health plan guidelines
• Oversee provision of ECM services and implementation of the Care Plan
• Connects with ECM member via phone or in-person to facilitate engagement, assessment, follow-up,
and education/training visits to develop and address the Care Plan.
• Works in conjunction with ECM member to identify Care Plan goals and objectives.
• Connects ECM member to other Community Supports / social services and supports he/she may need.
• Accompanies ECM member to office visits, as needed and according to health plan guidelines.
• Arranges transportation.
• Responsible to convene care conference meetings.
• Coordinates with ECM resource partners to obtain data/information to ensure accurate Care Plan
updates.
• Utilizes eCW and other electronic tracking systems to coordinate services and input data for reporting.
• Attends required ECM trainings.
• Facilitates internal ECM trainings/updates to T.H.E.'s clinical and administrative staff members.
• Collaborates with T.H.E.s IT department to ensure ECM templates are appropriate and effective at
capturing needed data/information.
• Reviews existing T.H.E.s protocols and polices to match ECM requirements.
• Develops new ECM protocols, policies, and accompanying workflows.
• Assists the required ECM reports and other internal reports.
• Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for
the Member and non-duplication of services
• Advocate on behalf of Members with health care professionals
• Use motivational interviewing, trauma- informed care, and harm-reduction approaches
• Coordinate with hospital staff on discharge plan
• Accompany Member to office visits, as needed and according to T.H.E. and MCP guidelines
• Monitor treatment adherence (including medication)
| May 2023
• Provide health promotion and self- management training
• Other duties as assigned.
Required Education and Qualifications:
• Bachelor's Degree in a healthcare, behavioral healthcare, social work, human services, or related field with
one year of experience, preferably in working with patients in a clinic setting, providing home health care
for patients, or social services case management services to low-income populations with one or more of
the following: complex chronic conditions, high utilizer of emergency room and tertiary health care
services, severe mental illness, and/or homelessness.
• Licensed Vocational Nurse (LVN), licensed behavioral health care professional, social worker, substance
abuse counselor, health educator, or other similar paraprofessional preferred.
• MPH or related fields preferred
• Bilingual in English/Spanish (oral and written)
Knowledge. Skills and Abilities:
• Strong documentation skills.
• Ability to multi-task and prioritize when needed.
• Ability to independently seek out resources and work collaboratively.
• Ability to develop and maintain good working relationships with staff.
• Ability to use computer and learn new software programs.
• Excellent interpersonal skills reflecting clarity, diplomacy, and the ability to communicate accurately
and effectively with all levels of staff and management.
• Demonstrates ability to work in a regulatory climate that includes oversight of state and federal
entities, payer contracts etc.
• Possesses ability to communicate effectively, both verbally and in writing.
• Proficient knowledge of Microsoft Outlook, MS Word, and Excel.
• Able to travel and attend professional meetings, conferences, trainings, and clinic sites.
• Performs other related duties as assigned.
Physical Demands:
The physical demands are representative of those that must be met by an employee to successfully perform
the essential functions of this job. Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit and talk or hear. The
employee is occasionally required to stand; use hands to handle or feel objects, tools, keyboards, or controls;
and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific
vision abilities required by this job include vision, distance vision, color vision, peripheral vision, depth
perception, and the ability to adjust focus.