Enhanced Care Management
We’re vastly improving health outcomes for high-need members by providing comprehensive care that goes beyond the hospital or doctor’s office. We’re breaking down the traditional walls of healthcare to improve the overall well being and quality of life for Medi-Cal members.
What is the Enhanced Care Management program?
Enhanced Care Management (ECM) is a free statewide Medi-Cal support service available to qualifying members with complex health and social needs as part of the DHCS’ CalAIM (Advancing and Improving Medi-Cal) program.
If you or someone you know might benefit from this program, please call us for more information or fill out our referral form.
Enhanced Care Management 
Enhanced Care Management Online Referral Form
Enhanced Care Management 
Transforming the complex needs of Medi-Cal members
Transforming the complex needs of Medi-Cal members
Medi-Cal members often have multiple complex physical, behavioral, and social conditions. They often have to manage several, complex systems to access care for each of their problems like primary and specialty care, dental, mental health, rehabilitation and substance use disorder treatment, and more.
Transforming the complex needs of Medi-Cal members
How does the ECM program work?
The program provides care management services directly to members from a dedicated Lead Care Manager (LCM) who coordinates all of their healthcare related needs and social services—advocating on their behalf while offering guidance, support and resources. LCMs establish high-trust and language-appropriate relationships with their members. LCMs meet members where they are, whether it’s at a coffee shop, a doctor’s appointment, at their home, shelter, or via phone or video call.
What are the services that ECM provides?
Enhanced Care Management helps Medi-Cal members in many ways:
Enhanced Care Management services
Doctors
Coordination of care
RX
Food
Housing
Dental and eye care
Medical supplies
Mental health
Transportation
Follow-up care
Enhanced Care Management services
Doctors
Coordination of care
RX
Food
Housing
Dental and eye care
Medical supplies
Mental health
Transportation
Follow-up care
Enhanced Care Management services
Doctors
Coordination of care
RX
Food
Housing
Dental and eye care
Medical supplies
Mental health
Transportation
Follow-up care
For Hospitals, Health Plans and IPA’s
- Identify and manage comprehensive needs for Medi-Cal members through ‘whole person care’ approaches and social drivers of health
- Improve quality outcomes, reduce health disparities, and transform the delivery system through value based initiatives, modernization, and payment reform
- Make Medi-Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility.
Titanium Healthcare participates in two main CalAIM programs:
1) The Enhanced Care Management (ECM) program
The ECM program focuses on the Social Determinants Of Health (SoDOH)
2) Community Supports (CS) Program
The CS program focuses on the homelessness and housing needs for the homeless population.
How can hospitals and IPAs get involved?
When hospitals and IPAs become a partner with Titanium Healthcare they can benefit from the CalAIM initiatives in many ways, including, but not limited to:
1) Providing long-term housing options for the homeless patients
2) Addressing social issues for high utilizers like food insecurity issues
3) Reducing occupied hospital beds “ED and Inpatient” with homeless members awaiting safe discharge
4) Reducing occupied hospital beds “ED and Inpatient” with SMI members awaiting transfer
The ECM and CS programs are a long-term solution, so it is very beneficial for the members and the healthcare systems like hospitals and IPAs to partner with ECM providers like Titanium.
For more information, please contact Marc Wirtz, Chief Operating Officer at: (909) 912-4382 or email: Marc.Wirtz@tihealthcare.com
Watch our video to learn about the ECM program:
ECM means better outcomes for everyone
The program helps members engage and take charge of their own healthcare. They are able to move safely between care settings and access community and social support services that greatly improves their health and social outcomes.
- High-need members get in-person care management where they live
- More coordinated, whole person care
- Reduction in frequent hospitalization
- Breaks down the traditional walls of health care, extending beyond hospitals and health care settings into communities
Why ECM matters?
Lower Costs, Healthier Lives
The Enhanced Care Management program reduces healthcare costs by delivering proactive, coordinated care that keeps people healthier and out of high-cost settings. By focusing on whole-person care, improving care coordination, and connecting individuals to essential community support services, ECM helps prevent avoidable emergency room visits and hospital readmissions—ultimately easing the financial burden on the healthcare system.
Improved Care Coordination
Dedicated Care Managers
Each eligible member is assigned a Lead Care Manager who works with them and their other providers to coordinate their care across different health systems.
We figure out what is not working and do something about it.
Comprehensive Assessments
Lead Care Managers conduct thorough assessments to identify all needs, including medical, behavioral, and social factors, and develop individualized care plans. This assessment becomes the basis for the relationship with Titanium.
Improved Care Coordination
Dedicated Care Managers
Each eligible member is assigned a Lead Care Manager who works with them and their other providers to coordinate their care across different health systems.
We figure out what is not working and do something about it.
Comprehensive Assessments
Lead Care Managers conduct thorough assessments to identify all needs, including medical, behavioral, and social factors, and develop individualized care plans. This assessment becomes the basis for the relationship with Titanium.
Improved Care Coordination
Dedicated Care Managers
Each eligible member is assigned a Lead Care Manager who works with them and their other providers to coordinate their care across different health systems.
We figure out what is not working and do something about it.
Comprehensive Assessments
Lead Care Managers conduct thorough assessments to identify all needs, including medical, behavioral, and social factors, and develop individualized care plans. This assessment becomes the basis for the relationship with Titanium.
Reduced Hospital Admissions (37% reduction)
Follow-up Care
Titanium works to understand the root causes for patient admissions. We find that many times, repeat admissions are preventable if we establish the root cause of a patient doing so. We also provide follow-up services after hospital discharge, helping to prevent readmissions by addressing discharge needs, providing medication support, and connecting members with needed resources. We find that focusing on this crucial time for a patient allows them a much better transition.
Early Intervention
By identifying individuals at risk for hospital admissions early on, we can intervene and prevent these admissions from occurring.
Reduced Hospital Admissions (37% reduction)
Follow-up Care
Titanium works to understand the root causes for patient admissions. We find that many times, repeat admissions are preventable if we establish the root cause of a patient doing so. We also provide follow-up services after hospital discharge, helping to prevent readmissions by addressing discharge needs, providing medication support, and connecting members with needed resources. We find that focusing on this crucial time for a patient allows them a much better transition.
Early Intervention
By identifying individuals at risk for hospital admissions early on, we can intervene and prevent these admissions from occurring.
Reduced Hospital Admissions (37% reduction)
Follow-up Care
Titanium works to understand the root causes for patient admissions. We find that many times, repeat admissions are preventable if we establish the root cause of a patient doing so. We also provide follow-up services after hospital discharge, helping to prevent readmissions by addressing discharge needs, providing medication support, and connecting members with needed resources. We find that focusing on this crucial time for a patient allows them a much better transition.
Early Intervention
By identifying individuals at risk for hospital admissions early on, we can intervene and prevent these admissions from occurring.
25% Drop in Emergency Room Visits with ECM Program
Focused Care
We dig deep to understand the root causes behind repeated emergency room visits. These unnecessary visits aren’t just costly to the healthcare system—they often reflect deeper issues that leave patients feeling frustrated and unwell. By identifying patterns and addressing the underlying factors driving ER use, we deliver targeted, compassionate care that keeps people healthier and out of crisis.
25% Drop in Emergency Room Visits with ECM Program
Focused Care
We dig deep to understand the root causes behind repeated emergency room visits. These unnecessary visits aren’t just costly to the healthcare system—they often reflect deeper issues that leave patients feeling frustrated and unwell. By identifying patterns and addressing the underlying factors driving ER use, we deliver targeted, compassionate care that keeps people healthier and out of crisis.
Reduced Hospital Admissions (37% reduction)
Focused Care
We dig deep to understand the root causes behind repeated emergency room visits. These unnecessary visits aren’t just costly to the healthcare system—they often reflect deeper issues that leave patients feeling frustrated and unwell. By identifying patterns and addressing the underlying factors driving ER use, we deliver targeted, compassionate care that keeps people healthier and out of crisis.
Shift in Focus to Preventative Care
Focus on Well-being
The ECM Program prioritizes preventing health problems and improving overall well-being, leading to fewer costly interventions later on.
Early Identification of Needs
The ECM Program identifies individuals with complex needs early on, allowing for proactive and targeted interventions.
Shift in Focus to Preventative Care
Focus on Well-being
The ECM Program prioritizes preventing health problems and improving overall well-being, leading to fewer costly interventions later on.
Early Identification of Needs
The ECM Program identifies individuals with complex needs early on, allowing for proactive and targeted interventions.
Shift in Focus to Preventative Care
Focus on Well-being
The ECM Program prioritizes preventing health problems and improving overall well-being, leading to fewer costly interventions later on.
Early Identification of Needs
The ECM Program identifies individuals with complex needs early on, allowing for proactive and targeted interventions.
Community-Based Care
In-person Care
We’re providing care in the community – right where its needed, reducing the need for expensive institutional care like nursing facilities.
Access to resources
The ECM Program connects members with community-based resources and services that can help them manage their health and well-being.
Community-Based Care
In-person Care
We’re providing care in the community – right where its needed, reducing the need for expensive institutional care like nursing facilities.
Access to resources
The ECM Program connects members with community-based resources and services that can help them manage their health and well-being.
Community-Based Care
In-person Care
We’re providing care in the community – right where its needed, reducing the need for expensive institutional care like nursing facilities.
Access to resources
The ECM Program connects members with community-based resources and services that can help them manage their health and well-being.
By implementing these strategies, we not only improve the quality of life of the members we serve, but we reduce hospitalizations by 37%. Emergency Room visits are reduced by 25%. What’s more, for every dollar that is invested in this program, we estimate over $3 returned in reduce waste and cost.
By implementing these strategies, we not only improve the quality of life of the members we serve, but we reduce hospitalizations by 37%. Emergency Room visits are reduced by 25%. What’s more, for every dollar that is invested in this program, we estimate over $3 returned in reduce waste and cost.
Who Provides Enhanced Care Management services?
Titanium Healthcare has been selected as an official provider of ECM services in California. Our program stands out for its personalized approach, our proficiency in multiple languages, our cultural understanding, and our deep commitment to helping our members and communities. Each member is paired with a dedicated, experienced Lead Care Manager who remains their constant support throughout their journey with us. Supporting our LCMs are teams of experienced nurses, housing navigators, continuity of care specialists, transitional care specialists, resource specialists, street outreach specialists, and ECM Leaders to ensure our members have access to the highest possible degree of care.
Our Care Management Leaders
Natalie Chermel, RN, BSN, RD
Director of Clinical Care Management
Fernando Suarez
Director of ECM
Central California and
High/Low Desert
Alexandra Mirassou
Director of ECM
Northern and Southern California
Patricia (Patty) Villasenor
Director of Outreach & Engagement
Jacob Dillon
ECM Regional Manager
Northern Californial
Eva Avalos
ECM Regional Manager
Southern California and High/Low Desert
Cristina Valderrama
ECM Regional Manager
Central California
Ericka Lomibao
ECM Regional Manager
Southern California
Natalie Chermel, RN, BSN, RD
Director of Clinical Care Management
Fernando Suarez
Director of ECM
Central California and
High/Low Desert
Alexandra Mirassou
Director of ECM
Northern and Southern California
Patricia (Patty) Villasenor
Director of Outreach & Engagement
Eva Avalos
ECM Regional Manager
Southern California and High/Low Desert
Cristina Valderrama
ECM Regional Manager
Central California
Ericka Lomibao
ECM Regional Manager
Southern California
Jacob Dillon
ECM Regional Manager
Northern California
Success Stories
Natalie Chermel, RN, BSN, RD
Director of Clinical Care Management
Natalie Chermel is the Director of Clinical Care Management at Titanium Healthcare, where she leads clinical operations and oversees multidisciplinary teams supporting high-risk member populations. She plays a key role in advancing care management, strengthening clinical workflows, and supporting quality initiatives that improve outcomes and member experience.
With over 10 years of experience as a Registered Nurse and Registered Dietitian, Natalie has worked across large health systems, small clinics, and startup environments. She is known for her proactive, compassionate, and innovative leadership style, strong drive, and commitment to helping individuals receive the care they deserve. Natalie holds a Bachelor of Science from Purdue University and a Bachelor of Science in Nursing from Marian University.
Alexandra Mirassou
Director of ECM Northern and Southern California
Allie has five years of experience providing case management to survivors of domestic violence and sexual assault, victims of crime, those with severe mental illness and substance use disorders, those experiencing homelessness, and those experiencing avoidable overutilization of the emergency department and hospitalizations.
She has managed quality assurance for Substance Use Disorder, Driving Under the Influence, and Whole Person Care programs. Allie has experience in Enhanced Care Management since its inception, through CalAIM, as a Practice Consultant at a managed care provider. Allie holds four post-high school degrees, including a Bachelor of Science in Family and Human Development, and a Masters of Social Work, and is currently pursuing a Doctorate in Behavioral Health Management. She is an Associate Clinical Social Worker acquiring hours for licensure.
Allie believes it is important to find where one can do the most good in the world; it is an honor to serve the ECM population and to assist people in reaching their goals, and highest level of independence. When not busy with work, school, or motherhood, Allie enjoys creating, including knitting, embroidering, crocheting, pickling, and making kombucha.
Cristina Valderrama
ECM Regional Manager Central California
Before joining Titanium, Cristina was a medical assistant for 33 years, working with both pediatrics and adults. She supervised Federally Qualified clinics in Santa Clara and also supervised a pediatric clinic for 16 years. Cristina worked for Octiva Healthcare (Titanium’s sister company) as a Lead Case Coordinator before joining Titanium as a Lead Care Manager in 2022. She became our Central California Regional Manager in 2024. Cristina enjoys helping underserved communities and watching all the accomplishments that the Titanium team have achieved for our members. Since joining us as Regional Manager, Cristina has been responsible for significant member growth in the Central California region.
Patricia (Patty) Villasenor
Director of Outreach & Engagement
Patricia joins us from a multifaceted background in community engagement, diversity & inclusion, and program management. She has left an indelible mark on various initiatives, including her role as the Director of Programs and Outreach at an economic justice non-profit, where she successfully implemented the Financial Wellness Promotora Program and the Open Air Economy program, tailored to the needs of Black Women and Latina Vendors.
As a recognized expert in diversity and inclusion, community outreach, and conflict management, Patricia has participated in numerous panels and developed various workshops and trainings on cultural competency, community engagement, and financial empowerment.
Jacob Dillon
ECM Regional Manager NorCal
Jacob is an accomplished healthcare and education professional dedicated to enriching the lives of individuals with diverse needs. With a proven track record of fostering positive outcomes and expanding services, Jacob brings expertise in DHCS regulations, healthcare programming, and LGBTQI+ community advocacy. Throughout his career, he has excelled in providing oversight and leadership to teams, developing and implementing innovative programs, and ensuring compliance with regulatory requirements. Jacob’s dedication to driving positive outcomes and advocating for improved community-based long-term care services is evident in his successful management of daily operations, provision of crucial support in crisis management situations, and collaboration with stakeholders to identify funding opportunities and expand services.
Jacob’s decision to join Titanium Healthcare was rooted in a profound alignment with the organization’s mission to revolutionize healthcare delivery. He finds inspiration in Titanium’s commitment to delivering comprehensive care to complex members and is driven to elevate the standard of care through innovative approaches and unwavering dedication. With his unique blend of skills, experience, and passion, Jacob is poised to make significant contributions to Titanium Healthcare’s mission and drive positive change in the industry.
Eva Avalos
ECM Regional Manager SoCal/High/Low Desert
Eva has been working in case management for over 20 years including community supports and ECM. Working with adults, children, and families who lived in shelters, group homes and/or experiencing homelessness. Worked in conjunction with several Regional Centers and Community Care Licensing in Southern California. Eva is passionate about enriching and making an impact on other people’s lives to achieve their goals.
Fernando Suarez
Director of ECM Central California and High/Low Desert
Before joining Titanium, he worked as a Physical Therapy Aide, and prior to his current role in Outreach, Fernando was a Titanium ECM Lead Care Manager. His passionate about making a difference in people’s lives and is dedicated to making the world a better place, one person at a time. Fernando graduated from the California State University of Los Angeles with a BS in Kinesiology and Exercise Science where he also volunteered at the university rehab center focusing on patients with stroke and spinal cord injuries.
Ericka Lomibao
ECM Regional Manager Southern California
Ericka has gained invaluable expertise in the Enhanced Care Management program, enhancing her ability to serve communities effectively. After earning a Bachelor of Science in Biology, she found the field unfulfilling and chose to pursue a Master’s in Public Health with an emphasis in Health Promotion, motivated by her desire to help others. With two years of case management experience, Ericka has discovered her true passion for supporting others and is committed to continuing her impactful work in the field.
Transplant Hope
Maria is 53-years old and has arthritis, hypertension, diabetes, and chronic kidney disease. She attends dialysis treatment at least three times a week and has been managing her kidney disease for over five years. During our first in-person encounter, we talked about a kidney transplant.
Collaborating with the social worker who provides services at Maria’s dialysis center, we were able to obtain an authorization from Maria’s health plan for her to be evaluated for a kidney transplant. Maria now has the appointment for evaluation scheduled. In our most recent meeting, she expressed joy as she shared that she is now “hopeful” about her future.
Transportation Sorted
Lupita, had an aneurysm and had undergone craniotomy surgery. She lives in a remote area far from the city and struggled to get to her appointments. Lupita’s roommate used to give her rides to her medical appointments, but is now unable. Lupita was anxious about missing her medical appointments as she couldn’t find a reliable alternative.
We helped arrange transportation services for her medical appointments and provided her with the contact number to call whenever she needed assistance. We also assured her that she can call us for help in setting up transportation whenever she needs to which she expressed deep gratitude and relief.
Mental health, the big picture
Bill, 35 years old, is one of our CalOptima patients and has been homeless and living in his car for about six years. Along with pancreatitis and some other medical issues (swollen legs, ankles, tinnitus), Bill also has an alcohol addiction. He had no doctor or care team before Titanium became involved in his care. We struggled to get Bill to talk about his alcohol problems, but eventually, we were able to get him into a sobriety and rehab center get him off the streets, and get him the medical and mental health care he needed. When we met with Bill last, he was doing well, is staying with the program, and is getting his life back on track.
*Members’ names and photos have been changed to protect their privacy.
Transplant Hope
Maria is 53-years old and has arthritis, hypertension, diabetes, and chronic kidney disease. She attends dialysis treatment at least three times a week and has been managing her kidney disease for over five years. During our first in-person encounter, we talked about a kidney transplant.
Collaborating with the social worker who provides services at Maria’s dialysis center, we were able to obtain an authorization from Maria’s health plan for her to be evaluated for a kidney transplant. Maria now has the appointment for evaluation scheduled. In our most recent meeting, she expressed joy as she shared that she is now “hopeful” about her future.
Transportation Sorted
Lupita, had an aneurysm and had undergone craniotomy surgery. She lives in a remote area far from the city and struggled to get to her appointments. Lupita’s roommate used to give her rides to her medical appointments, but is now unable. Lupita was anxious about missing her medical appointments as she couldn’t find a reliable alternative.
We helped arrange transportation services for her medical appointments and provided her with the contact number to call whenever she needed assistance. We also assured her that she can call us for help in setting up transportation whenever she needs to which she expressed deep gratitude and relief.
Mental health, the big picture
Bill, 35 years old, is one of our CalOptima patients and has been homeless and living in his car for about six years. Along with pancreatitis and some other medical issues (swollen legs, ankles, tinnitus), Bill also has an alcohol addiction. He had no doctor or care team before Titanium became involved in his care. We struggled to get Bill to talk about his alcohol problems, but eventually, we were able to get him into a sobriety and rehab center get him off the streets, and get him the medical and mental health care he needed. When we met with Bill last, he was doing well, is staying with the program, and is getting his life back on track.
*Members’ names and photos have been changed to protect their privacy.
Titanium Healthcare Inc./Sterling Hospitalist Medical Group.
12566 Valley View Street, Garden Grove, CA 92845
ECM Helpline: (310) 280-5203
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© Titanium Healthcare® Inc. | All Rights Reserved.
© Titanium Healthcare® Inc. | All Rights Reserved.