CalAIM Quality Assurance Specialist
Titanium Healthcare Inc.
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $70,000 - $75,000 per year
About the role
- Conduct routine chart audits to evaluate documentation accuracy, completeness, and alignment with CalAIM program and Managed Care Plan requirements
- Review member encounters, care management documentation, outreach efforts, and service plans to ensure services are properly documented
- Identify documentation gaps, workflow challenges, or compliance risks and communicate findings to leadership
- Track audit findings and monitor trends in documentation quality across teams and regions to inform quality improvement efforts
- Monitor compliance with CalAIM program requirements and Managed Care Plan guidelines
- Support internal reviews and external audits by preparing documentation and assisting leadership with audit preparation
- Support the collection and review of audit results and quality metrics
Requirements
- Associate or bachelor’s degree in public health, social work, healthcare administration, human services, or another related field
- Minimum 2+ years of experience working in a Medi-Cal program environment, such as Enhanced Care Management, Community Supports, Health Homes, care coordination, or case management
- Experience reviewing or documenting member records within an electronic health record system, including encounters, case notes, care plans, or service documentation
- Strong understanding of documentation standards and program compliance requirements, with experience reviewing member records and identifying documentation or regulatory gaps
- Ability to interpret program requirements, policies, and health plan guidance and apply them during documentation review
- Strong attention to detail with the ability to review documentation for accuracy, completeness, and compliance with program standards
- Excellent written and verbal communication skills, with the ability to clearly document audit findings and communicate feedback to staff and leadership
- Analytical thinking and problem-solving skills to identify documentation trends, workflow gaps, and opportunities for improvement
- Proficiency in Microsoft Office applications including Excel, Teams, and SharePoint for tracking, reporting, and collaboration
- Ability to communicate clearly and professionally through virtual meeting platforms and written communication tools
Benefits
- Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
- Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, reproductive loss, and therapy
- Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
- Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
- 401(k) plan
- Employee Assistance Programs
- Protect your pet(s) with Pet Insurance
- Life/AD&D insurance funded 100% by Titanium Healthcare
- Flexible Spending, Health Savings & Dependent Care Accounts
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
chart auditsdocumentation accuracycompliance monitoringquality improvementelectronic health record systemdocumentation standardsregulatory compliancedata analysisreportingcare coordination
Soft Skills
attention to detailwritten communicationverbal communicationanalytical thinkingproblem-solvingfeedback communicationinterpersonal skillsorganizational skillscollaborationworkflow analysis