CalAIM Quality Assurance Specialist

Titanium Healthcare

10d•$70,000 - $75,000•Remote

About The Position

Titanium Healthcare is seeking a detail-oriented and analytical Quality Assurance Specialist to support oversight of our CalAIM programs, including Enhanced Care Management (ECM), Community Supports (CS), and Health Home Program (HHP). The Quality Assurance Specialist monitors documentation quality, conducts chart audits, and reviews member records to ensure compliance with CalAIM and Managed Care Plan requirements while identifying opportunities to strengthen workflows, documentation standards, and overall program performance. This role works closely with the Director of Education & Quality Assurance, program leadership, and frontline teams to ensure documentation practices align with regulatory expectations and support ongoing audit readiness across the organization. At Titanium Healthcare, you will be part of a mission-driven team dedicated to advancing health equity across California. As a Quality Assurance Specialist, you will play a key role in strengthening documentation quality, supporting compliance with state and health plan requirements, and improving the delivery of care across our CalAIM programs. We offer competitive pay, comprehensive benefits, and opportunities for professional growth in an organization that values innovation, accountability, and collaboration.

Requirements

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 work independently while collaborating effectively with program leadership, training teams, and operational staff
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
Ability to interpret program requirements, policies, and health plan guidance and apply them during documentation review
Strong organizational and time management skills, with the ability to manage multiple audits and competing priorities
Proficiency in Microsoft Office applications including Excel, Teams, and SharePoint for tracking, reporting, and collaboration
Comfort working within electronic health record systems to review member documentation and service records
Consistently operates a computer and standard office equipment in a home-office or remote work environment
Must be able to remain in a stationary position for extended periods while reviewing documentation, completing chart audits, and preparing reports
Ability to communicate clearly and professionally through virtual meeting platforms and written communication tools
Ability to work across multiple digital systems, including electronic health records, reporting tools, and collaboration platforms
Occasionally required to move or carry materials up to 15 pounds
This position is primarily remote, with occasional travel (less than 10%) for meetings, trainings, or organizational events
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
Distraction-free home workspace with a secure internet connection

Nice To Haves

Experience working within California’s CalAIM initiative, including Enhanced Care Management (ECM), Community Supports (CS), or the Health Home Program (HHP)
Experience conducting chart audits, documentation reviews, or supporting internal quality monitoring and audit preparation activities
Familiarity with Managed Care Plan documentation requirements and Medi-Cal program compliance expectations
Experience using eClinicalWorks (eCW) or a comparable electronic health record system
Background in care coordination, case management, housing navigation, or community-based services serving Medi-Cal populations
Experience collaborating with program leadership or training teams to strengthen documentation practices and program workflows

Responsibilities

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
Maintain awareness of regulatory updates, health plan guidance, and documentation standards impacting program operations
Support internal reviews and external audits by preparing documentation and assisting leadership with audit preparation
Assist in monitoring corrective actions and follow-up activities related to audit findings
Support the collection and review of audit results and quality metrics
Collaborate with program managers and data teams to analyze trends in documentation quality and program performance
Prepare summaries and reports related to audit outcomes, documentation trends, and quality improvement initiatives
Provide guidance to program staff regarding documentation standards and compliance expectations
Collaborate with Training and Program Leadership to identify areas where staff may benefit from additional training or workflow clarification
Support the development of job aids, documentation guidance, and quality improvement initiatives that strengthen program performance
Perform other duties and projects as assigned

Benefits

Make an impact: an organization who cares about its employees, communities, and the future of healthcare
Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
Growth: opportunities to develop and grow your career with us
Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business
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
Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
Flexible Spending, Health Savings & Dependent Care Accounts
Life/AD&D insurance funded 100% by Titanium Healthcare
Supplemental Short-Term Disability
Employee Assistance Programs
Protect your pet(s) with Pet Insurance
401(k) plan