Job Description

Overview

We are seeking dedicated, community-based Community Health Workers (CHWs) to join our Enhanced Care Management (ECM) division. In this role, you will conduct in-person outreach, engagement, and care coordination with Medi-Cal members across Santa Barbara and San Luis Obispo Counties.

Our CHWs are the frontline of the ECM program--meeting members where they live, seek care, or prefer to receive support, and helping them access needed services, resources, and care. This is a high-touch, relationship-centered role requiring empathy, persistence, and comfort working in the field.

Key Responsibilities

1. Outreach & Engagement

Conduct in-person contact attempts to all newly assigned ECM members, following program timelines and outreach protocols.
Mandated as primary modality for ECM outreach.

Complete follow-up outreach attempts using approved communication methods (phone, text, mail, email, telehealth). Prioritize outreach to members with the greatest clinical or social complexity.
2. Field-Based Member Support

Meet members in the community (homes, shelters, treatment programs, hospitals, etc.) to provide direct support. Assist members in identifying needs related to:Physical health, Mental health, Substance use, Housing, Social determinants of health, Community resource access Build trusting relationships that encourage engagement in their care plan.
3. Care Coordination Support

Support the Lead Care Manager in implementing the member's care plan, including: Scheduling appointments Providing reminders Coordinating transportation Helping obtain needed documentation Facilitating warm hand-offs to services Accompanying members to critical appointments as needed Ensure communication with the care team is culturally and linguistically appropriate.
4. Documentation & Communication

Document all outreach attempts, contacts, assessments, and follow-ups in the care management platform in a timely and accurate manner.
ECM Providers must use structured systems that support multidisciplinary coordination.

Communicate member preferences, needs, and updates to the Lead Care Manager and broader care team.
5. Member & Family Support

Help members and their caregivers understand care instructions, available services, and how to navigate the health system. Identify needed supports for family/caregivers to assist the member. Ensure members receive a copy of their care plan and understand how to request updates.
6. Community and Social Service Linkages

Connect members to community resources such as housing programs, food support, social services, and other Community Supports. Conduct closed-loop referrals, ensuring services were successfully accessed.
7. Program Compliance

Participate in required CHW and ECM training sessions provided by the organization and managed care plans. Follow all ECM program standards, confidentiality rules, and culturally appropriate communication practices.

Qualifications

Required

Experience working with high-need or vulnerable populations (e.g., homelessness, SMI, SUD, chronic health conditions, justice-involved individuals). Comfort conducting field-based work in diverse environments across Santa Barbara and/or San Luis Obispo Counties. Strong interpersonal and communication skills, including the ability to engage members who may be difficult to reach. Ability to maintain clear, timely documentation. Valid driver's license, reliable transportation, and ability to travel throughout the region.

Preferred

Experience providing case management, outreach, peer support, or health navigation. Familiarity with Medi-Cal populations or community health programs. Bilingual capability (Spanish preferred). Experience collaborating with hospitals, primary care, behavioral health, shelters, or community-based organizations.
Attributes for Success

Empathetic and patient-centered Persistent and creative in outreach attempts Comfortable working independently in the field Highly organized and reliable Collaborative and team-oriented Strong cultural humility
Compensation & Benefits

Competitive hourly wage based on experience Mileage reimbursement Health insurance package Paid time off Opportunities for advancement within the ECM division
Job Types: Full-time, Part-time

Pay: $24.72 - $29.77 per hour

Expected hours: 10 - 40 per week

Benefits:

401(k) Dental insurance Health insurance Vision insurance
Work Location: In person