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Titanium Healthcare Inc.

CalAIM Quality Assurance Specialist

Posted 2 Days Ago
Remote
Hiring Remotely in California
Mid level
Remote
Hiring Remotely in California
Mid level
The Quality Assurance Specialist conducts audits and monitors compliance of documentation in CalAIM initiatives, identifying gaps and improving workflows.
The summary above was generated by AI

WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.


Join us in our mission!


Titanium Healthcare is committed to advancing health equity through California’s CalAIM initiative, including the Enhanced Care Management (ECM), Community Supports (CS), and Health Home Program (HHP). We support some of the most vulnerable members of our communities by providing high-quality person-centered care coordination.


Our teams are collaborative, mission-driven, and focused on delivering services that meet the highest standards of quality and compliance. Through strong operational systems, training, and quality oversight, Titanium Healthcare works to ensure that every member receives coordinated and effective care.


POSITION SUMMARY

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.


WHERE YOU’LL WORK

This position is remote. Standard business hours are Monday through Friday from 8:00 am to 5:00 pm.


WHAT YOU’LL DO

Quality Monitoring & Chart Review

  • 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

Compliance and Audit Readiness

  • 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

Data Monitoring and Reporting

  • 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

Staff Support and Quality Improvement

  • 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

WHO YOU ARE

  • 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

WHAT YOU’LL NEED

  • 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

WHAT YOU’LL ENJOY

  • 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 


EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.


Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.

Top Skills

Eclinicalworks
Electronic Health Record Systems
MS Office

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