quality assurance specialist Jobs in Los Angeles

quality assurance specialist

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behavioral health medical director

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benefits coordination specialist

clinical case manager, behavioral health Jobs in Los Angeles

clinical case manager, behavioral health

behavioral health quality manager

JWCH Institute

<div>Position Purpose:
The Behavioral Health Quality Assurance Manager is responsible for quality assurance and training for all Department of Mental Health programs. The position upholds the JWCH mission to improve the health status and wellbeing of under-served segments of the population of Los Angeles County through the direct provision or coordination of health care, health education, services, and research. This includes interviewing, treating, coordinating, planning, and linkage to a full-range of resources that meet practical, social, and emotional needs, in collaboration with a multidisciplinary team and community-based programs. As a result, patient outcomes and satisfaction are improved, along with organizational fiscal capacity.
Principal Responsibilities:<ul><li>
Increase productivity through quality assurance measures</li><li>
Clear understanding of Department of Mental Health programs</li><li>
Providing oversight and supervision for identified staff</li><li>
Develop &amp; maintain training manual and procedures for new hires and current staff</li><li>
Develop and maintain Policies &amp; Procedures (P&amp;Ps) that are aligned with DMH standards</li><li>
Attend and represent the agency at outside meetings to keep aware of new bulletins and distributing information to Leads/Programs</li><li>
Assist in internal compliance meetings</li><li>
Understand Electronic Health Recording (EHR) system, Welligent and Nextgen</li><li>
Provide and/or arrange ongoing Professional Development for clinicians and other providers</li><li>
Provide continuous improvement on systems for screening, referral, enrollment using LEAN/PDSA process.</li><li>
Design and maintain training and QA program for staff which includes monthly peer reviews and DMH QA plan yearly</li><li>
Review and analyze electronic health recording reports to ensure compliance</li><li>
Create materials need for program documentation including but not limited to worksheets, chart checklists, manuals, and monthly newsletters.</li><li>
Oversee all charting required by DMH, including assessments, progress notes, care plans, and billing documentation.</li><li>
Adhere to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.</li><li>
Participate in required safety and compliance trainings and apply learned practices in daily work activities.</li><li>
Identify, report, and help mitigate unsafe conditions, incidents, or hazards in the workplace.</li><li>
Use equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.</li><li>
Maintain awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.</li><li>
Complete data collection forms and prepare reports as required by the program.</li><li>
Other duties as assigned</li></ul>
Requirements:<ul><li>
Master&rsquo;s degree in social work, social welfare, psychology, marriage, family and child counseling, and or marriage and family therapy from an accredited college or university.</li><li>
MFT / LCSW with current California BBS license for 2 years</li><li>
Administrative experience with coordinating care across multiple programs, for 2 or more years</li><li>
Experience with Electronic Health Recording</li><li>
Experience overseeing Department of Mental Health contracts for 2 or more years.</li><li>
Experience supervising clinical staff and interns for 2 or more years</li><li>
Experience with quality assurance and contract compliance for 2 or more years</li><li>
Experience working with low income and/or homeless individuals</li><li>
Demonstrated understanding of the impact of trauma and substance abuse on behavioral and medical conditions</li><li>
Knowledgeable of evidence-based treatments (DBT, CBT, Seeking Safety, Motivational Interviewing)</li><li>
Bilingual (English/Spanish) ability preferred.</li><li>All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated against COVID-19.</li></ul>
Become part of a team where your work matters. Apply today and help us change lives, one patient at a time.
JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.</div>

Behavioral Health Quality Manager

Heluna Health

<div>Salary Range: $32.96-$45.04 per hour

SUMMARY

The Los Angeles County Department of Homeless Services and Housing (HSH) consolidates our countywide response to homelessness. The driving force behind HSH is increasing accountability and transparency, improving care for people experiencing or at risk of homelessness, and streamlining collaboration with partners including services providers, the County&rsquo;s 88 cities, and unincorporated areas to deliver high-quality, life-saving care. Staff schedules are based on business need and may include the option of a hybrid work schedule where employees work remotely, in the field and from the office.

This position is for a Clinical Social Worker with the department of HSH and will support the Enriched Residential Care (ERC) program and Interim Housing (IH) sites. The role will entail both direct care to patients through quality clinical bio-psychosocial assessments of patients and technical assistance (TA) and training support to on-site staff on behavioral health issues. The focus on this role will be to provide short-term behavioral health services, evidence-based treatment services to certain complex high acuity patients and also provide training and support to onsite staff at the different sites to support/improve their management of complex patients.

This position is expected to function with a degree of independence and be self-directed as this role works with individualized treatment plans and with onsite staff to accomplish changes in insight, attitudes, and motivations of patients, family and staff to attain optimal health functioning. This position demands professional skills that may include additional expertise in specific therapeutic methods such as motivational interviewing, cognitive behavioral therapy, relapse prevention therapy, and trauma-informed care.

The Clinical Social Worker must possess a comprehensive knowledge of established professional standards and principles, pertinent policies and procedures of the department and the assigned facility, community resources available for referral, and State and Federal social welfare laws and regulations. The position reports to the ERC Clinical Social Work Supervisor and works under the direction of the clinical social work supervisor.

ESSENTIAL FUNCTIONS
<ul>
<li>Assesses and treats the complicated psychosocial problems of patients including but not limited to untreated or under- treated mental health or substance abuse conditions, economic instability, legal problems, and inadequate social support, housing and transportation.</li>
<li>Works closely with and in partnership with ERC medical case workers, medical team, program managers and other HSH staff for complicated high acuity patients to assess, develop, and help implement care plans for the patients/ participants</li>
<li>Responds to requests for consultation and brief intervention around functional decline related to mental health and/or substance use, behavioral challenges, and higher level of care cases. This will include carrying a caseload, as needed, of clients needing short-term intervention and stabilization.</li>
<li>Provides consultation to team members, community partners, and /or other staff at the sites or facilities in delivery of care support management of chronic medical and behavioral condition.</li>
<li>Provides direct services when needed to patients/participants by conducting a face-to-face comprehensive behavioral health assessment and develops care planning/treatment plans for patients that address the patient&rsquo;s mental health, substance abuse and behavioral health needs. This includes helping to coordinate SUD and/or mental health services on behalf of the client.</li>
<li>Utilizes motivational interviewing and a trauma informed approach when providing direct services or when providing consultation to other team members in how to support patients.</li>
<li> Complete required documentation in EMR for any direct services provided and create or updates client care plan identifying wrap around supports that align with assessment.</li>
<li> Participate in case conference with the care team, as needed.</li>
<li>Provides technical assistance (TA) and training support to Facility Administrators, facility staff, or IH on-site staff as needed to address mental health and behavioral health issues and support staff in the management of behavioral health issues.</li>
<li>Develops and deliver education and/or training to staff on various mental health topic or mental health resources that help non-clinical providers identify and support residents who have behavior issues that are impacting their functioning and related to mental health and/or substance use issues</li>
<li>Provides education and training programs to other team members on how to implement trauma informed care, harm reduction and housing first models</li>
<li>Provides training implementation support that may include educational outreach visits, consultation, shadowing opportunities, modeling and developing site-specific protocols, techniques, and tools as needed</li>
<li>Conducts and /or participate in meetings/ case conference with ERC facility or IH sites to provide individualized interactive problem-solving support targeting provider and/or residents&rsquo; needs</li>
<li>Works with HSH staff to help perform facility-oriented evaluations to improve the physical and social environmental impact on clients, functioning as part of ongoing quality assurance efforts</li>
<li>Works with HSH staff in developing collaborative relationships with ERC facilities and housing and service providers to co-learn and tailor sustainable, responsive, site-specific assistance for change</li>
<li>May work with Clinical Social work supervisor on other macro issues/projects as needed, including liaising with Mental Health and SUD Services for Care Coordination</li>
<li>Participates in performance/quality improvement (PI/QI) activities and contributes to policy development as needed.</li>
</ul>
JOB QUALIFICATIONS

A Master's Degree in Social work from a graduate school accredited by the Council on Social Work Education including supervised clinical social work field work experience - OR - A Master's Degree in Social Work from a graduate school accredited by the Council on Social Work Education and one year of experience in medical, community, psychiatric, family, or child welfare social work involving problems of medical, mental, or emotional adjustment.

Certificates/Licenses/Clearances
<ul>
<li>A valid, current license as a Licensed Clinical Social Worker issued by the California Board of Behavioral Sciences OR registration in good standing as an Associate Clinical Social Worker with the California Board of Behavioral Sciences within six (6) months of employment. Associate Clinical Social Workers must remain in good standing with the California Board of Behavioral Sciences for the duration of the waivers permitted by law, not to exceed six years.</li>
<li>A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.</li>
</ul><ul><li>Successful clearance of the Live Scan process and health clearance with the County of Los Angeles.</li>
</ul>
Other Skills, Knowledge, and Abilities
<ul>
<li>Clinical social work in Homeless health care experience</li>
<li>Experience/expertise in assessing and managing clients with dysfunctional SUD Experience/expertise in assessing and managing clients with severe persistent mental illness.</li>
<li>Experience/expertise in trauma-informed care and harm reduction principles</li>
<li>Demonstrated teaching and communication skills with clinical and non-clinical staff.</li>
<li>Experience providing clinical and administrative supervision to other behavioral health staff preferred.</li>
<li>Familiarity with DMH, DPH and community mental health and substance use programs and Excellent documentation and clinical skills, ability to set priorities, work independently, works well under pressure and meet deadlines.</li>
<li>Experience with complex case management, outreach, and home visits.</li>
<li>Must demonstrate cultural humility and a strength-based, recovery philosophy.</li>
<li>Must be able to move between different treatment approaches (clinical case management and evidence-based, trauma-focused psychotherapy) depending on the needs of the client.</li>
<li>Excellent organizational and strong interpersonal skills.</li>
<li>Must demonstrate an understanding of trauma-informed care and housing first models</li>
<li>Proficient with Microsoft Office applications (Word, Excel, PowerPoint, Outlook, Teams) and Adobe Acrobat software.</li>
<li>Knowledge of the functioning of the healthcare setting.</li>
<li>Strong verbal and written communication skills.</li>
<li>Excellent time management skills.</li>
</ul>
PHYSICAL DEMANDS

Stand: Frequently

Walk: Frequently

Sit: Frequently

Reach Outward: Occasionally

Reach Above Shoulder: Occasionally

Climb, Crawl, Kneel, Bend: Occasionally

Lift / Carry: Occasionally - Up to 15lbs

Push/Pull: Occasionally - Up to 15lbs

See: Constantly

Taste/ Smell: Not Applicable 


Not Applicable = Not required for essential functions

Occasionally = (0 - 2 hrs/day)

Frequently = (2 - 5 hrs/day)

Constantly = (5+ hrs/day)

WORK ENVIRONMENT

General Office Setting, Indoors Temperature Controlled

EEOC STATEMENT

It is the policy of Heluna Health to provide equal employment opportunities to all employees and applicants, without regard to age (40 and over), national origin or ancestry, race, color, religion, sex, gender, sexual orientation, pregnancy or perceived pregnancy, reproductive health decision making, physical or mental disability, medical condition (including cancer or a record or history of cancer), AIDS or HIV, genetic information or characteristics, veteran status or military service.</div>

Clinical Social Worker - ERC (N289)

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community 
</h1>
The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models. Maintains efficient operations while ensuring attainment of quality of care and financial goals. Provides information for pricing guidelines based on utilization patterns and client demographics. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise.
The Behavioral Health Medical Directors will learn Medicare, Medicare Advantage and/or Medicaid requirements, and will understand how to operationalize this knowledge in their daily work.
The Behavioral Health Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Behavioral Health Medical Directors support Humana values, and Humana&rsquo;s Bold Goal mission, throughout all activities.<h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications<ul><li>MD or DO degree</li><li>5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population</li><li>Current and ongoing Board Certification an approved ABMS Medical or ABPN Specialty</li><li>A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.</li><li>No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.</li><li>Excellent verbal and written communication skills .</li><li>Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.</li></ul>
Preferred Qualifications<ul><li>Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.</li><li>Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.</li><li>Experience with national guidelines such as MCG&reg; or InterQual</li><li>Psychiatry, Internal Medicine, Family Practice, Geriatrics, Hospitalist, or Emergency Medicine clinical specialists</li></ul>
&bull; Advanced degree such as an MBA, MHA, MPH&bull; Exposure to Public Health, Population Health, analytics, and use of business metrics.<ul><li>Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.</li><li>The curiosity to learn, the flexibility to adapt and the courage to innovate</li></ul>
Additional Information
Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business.
#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$223,800 - $313,100 per year 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Behavioral Health Medical Director

CVS Health

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary:
Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. 
Assessment of Members:<ul><li>
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member&rsquo;s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member&rsquo;s benefit plan and available internal and external programs/services.</li><li>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.</li><li>
Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.</li><li>
Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services.</li></ul>
Enhancement of Medical Appropriateness and Quality of Care:<ul><li>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits</li><li>
Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes</li><li>
Identifies and escalates quality of care issues through established channels</li><li>
Ability to speak to medical and behavioral health professionals to influence appropriate member care.</li><li>
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health</li><li>
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.</li><li>
Helps member actively and knowledgably participate with their provider in healthcare decision-making</li><li>
Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.</li></ul> 
Monitoring, Evaluation and Documentation of Care<ul><li>
In collaboration with the member and their care team develops and monitors established plans of care to meet the member&rsquo;s goals</li><li>
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.</li><li>
Ability to take and manage crisis calls.</li></ul> 
Required Qualifications:<ul><li>
Unencumbered Independent Behavioral Health clinical license in the state where they reside and work:</li></ul><h3 class="jobSectionHeader">
Licensed Mental Health Counselor (LMHC)</h3><h3 class="jobSectionHeader">
Licensed Clinical Social Worker (LCSW)</h3><h3 class="jobSectionHeader">
Licensed Independent Social Worker (LISW)</h3><h3 class="jobSectionHeader">
Licensed Marital and Family Therapist (LMFT)</h3><h3 class="jobSectionHeader">
Licensed Professional Counselor (LPC)</h3><ul><li>
3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility</li><li>
3+ years minimum of Behavioral Health experience</li><li>
Applicants must be willing to work standard business hours in EST or CST.</li></ul> 
Preferred Qualifications<ul><li>
Case management and discharge planning experience
</li><li>Crisis intervention skills
</li><li>Managed care/utilization review experience
</li><li>Ability to take and manage crisis calls</li></ul>
Education
Minimum of a Master&rsquo;s degree in Behavioral/Mental Health or related field
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,095.00 - $142,576.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. 
Additional details about available benefits are provided during the application process and on Benefits Moments. 
We anticipate the application window for this opening will close on: 05/02/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Clinical Case Manager, Behavioral Health

Pacific Asian Counseling Services

Position Description:PACS is seeking a motivated and community-driven Case Manager to join our Intensive Services team.This role is part of our Full-Service Partnership (FSP) program, providing intensive, community-based mental health services to individuals with complex behavioral health needs. Clients may experience serious mental illness, housing instability, co-occurring conditions, and other high-acuity challenges.The Case Manager plays a critical role in delivering hands-on, field-based support that promotes stability, independence, and overall well-being. This is not a desk-based role, staff work directly in the community, meeting clients where they are and helping them navigate systems such as housing, healthcare, and public benefits.Experience and Essential Job Functions:<ul><li>Provide comprehensive case management services in collaboration with the multidisciplinary treatment team.</li><li>Assist in developing, implementing, and monitoring individualized treatment plans.</li><li>Coordinate and link clients to housing, healthcare, benefits (SSI/SSDI, Medi-Cal, CalFresh, etc.), employment, and substance use services.</li><li>Advocate for clients to reduce barriers and improve access to care.</li><li>Conduct home visits and provide services in community settings.</li><li>Provide transportation and accompany clients to appointments when appropriate.</li><li>Build strong, trusting relationships through consistent outreach and engagement.</li><li>Support crisis intervention efforts alongside the clinical team.</li><li>Assist clients in developing daily living skills and increasing independence.</li><li>Reinforce treatment goals and support behavioral health interventions.</li><li>Participate in outreach to engage potential clients and support enrollment.</li><li>Build relationships with community partners and service providers.</li><li>Assist in facilitating workshops, groups, and community activities.</li><li>Complete timely and accurate documentation of services.</li><li>Maintain productivity and billing requirements.</li><li>Participate in team meetings, case conferences, and trainings.</li><li>Perform additional responsibilities as assigned.</li></ul>Minimum Qualifications:<ul><li>Bachelor's degree in social work, Psychology, or related field, or</li><li>Associate&rsquo;s degree with relevant experience, or</li><li>Experience working with serious mental illness, homelessness, or co-occurring disorders.</li><li>Experience in community mental health or field-based settings.</li><li>First Aid and CPR training (training provided if not currently certified).</li></ul>Preferred Qualifications:<ul><li>Bilingual (Spanish, API languages, or other threshold languages).</li><li>Knowledge of community resources and social service systems.</li><li>Ability to work with diverse populations using a trauma-informed approach.</li><li>Strong communication, organization, and documentation skills.</li><li>Ability to work independently in a fast-paced, field-based environment.</li><li>Ability to respond appropriately in crisis situations.</li><li>Ability to travel throughout Los Angeles County.</li><li>Valid driver&rsquo;s license, reliable transportation, and proof of insurance required.</li><li>Knowledge of HIPAA and mandated reporting.</li></ul>Job Perks:<ul><li>Comprehensive medical, dental, and vision coverage with low premium contributions.</li><li>401(k) retirement plan.</li><li>Professional development support including opportunities for growth.</li><li>Paid holidays and vacation time.</li><li>Mileage reimbursement.</li><li>Partial reimbursement for cell phone and internet expenses.</li></ul>Pay: $27.00 - $30.00 per hourBenefits:<ul><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Vision insurance</li></ul>Education:<ul><li>Master's (Preferred)</li></ul>Language:<ul><li>Bilingual (Spanish, API languages) (Preferred)</li></ul>Work Location: Hybrid remote in Los Angeles, CA 90045

Case Manager – FSP

Pair Team

<div><h2 class="jobSectionHeader">About Pair Team</h2> 


At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.

We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.

Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.

We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.

At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare. 


Our Values
<ul>
<li>Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.</li>
<li>Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.</li>
<li>Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.</li>
<li>Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.</li>
<li>Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.</li>
</ul><h3 class="jobSectionHeader">In the News</h3>
<ul><li>Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most</li>
<li>TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team</li>
<li>Axios: Pair Team collects $9M for Medicaid-based care</li>
</ul>
<h2 class="jobSectionHeader"> 
About the Opportunity</h2>

Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Lead Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.

We seek a full-time Lead Care Manager to play a critical role in our whole-person, interdisciplinary care model, responsible for directly outreaching and engaging with individuals living with Serious Mental Illness/ Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. We believe in the power of trust and relationships to successfully engage those who may have never received the kind of whole-health care that Pair Team can provide. 

This position primarily allows for remote work; however, it includes 2-3 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 2-3 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home 

<h3 class="jobSectionHeader">
What You'll Do</h3>
<ul><li>Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals</li>
<li>Use relationship-based strategies to support members with social support navigation, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system</li>
<li>Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members</li>
<li>Work with member to identify health/wellness goals and incorporate goals into Health Action Plan/Shared Care Plan</li>
<li>Supports nurse care manager, behavioral health care manager, nurse practitioner and Community Engagement Specialist with delegated tasks</li>
<li>Collaborates on care issues with Enhanced Care Management team by participating in systematic case reviews and consulting with nurse care manager, behavioral health care manager, and nurse practitioner before taking clinical actions</li>
<li>Consistently meet monthly encounter metrics to ensure compliance with health plan regulations</li>
<li>Identify and break down barriers ensuring individuals' continuation with the program</li>
<li>Assists individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups</li>
<li>Coordinate physical care management appointments through collaboration with external and internal providers</li>
<li>Utilize external and internal online platforms to collaborate with team members and carry out daily tasks</li></ul> 

<h3 class="jobSectionHeader">
What You'll Need</h3>
<ul><li>1+ years of general work experience (Case Management preferred)</li>
<li>You are physically located in California
<ul><li>Field Ops requires you to maintain reliable transportation for engagement at clinic, community based organization, and health system partner locations</li>
<li>Virtual Ops requires a quiet, HIPAA compliant and internet connected space</li>
</ul></li><li>Bilingual &ndash; English/Spanish</li>
<li>Strong understanding of cultural fluency</li>
<li>High degree of empathy</li>
<li>Ability to work collaboratively in a multidisciplinary team</li>
<li>An eye for optimization</li>
<li>Organizational skills</li>
<li>Ability to remain patient when faced with adversity</li>
<li>Strong technical skills and comfort with technology innovation, past experience with CRM databases, basic Excel, Word, email, and video conferencing</li>
<li>A valid driver's license and auto liability insurance</li>
</ul><h3 class="jobSectionHeader">Preferred Qualifications:</h3>
<ul><li>Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder</li>
<li>2+ years of case management experience</li>
<li>Experience with motivational interviewing</li>
<li>Knowledge of medical terminology</li>
<li>Zest for problem solving, seeking answers, and thinking outside the box</li>
<li>Detail-oriented and organized self-starter who is a rockstar multitasker</li>
<li>Reliable and comfortable in an ever-changing environment</li></ul> 

<h3 class="jobSectionHeader">
Because We Value You</h3>
<ul><li>Salary: $22-$25/hour</li>
<li>Comprehensive health, vision &amp; dental insurance</li>
<li>401k</li>
<li>Monthly $100 work from home expense stipend for your WFH days</li>
<li>Gas reimbursements for your on-site engagement days</li>
Flexible vacation policy <li>- take the time you need to recharge!</li>
<li>We provide all of the equipment needed for the role</li>
<li>Opportunity for rapid career progression with plenty of room for personal growth!</li></ul><div> 
Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.

Pair Team participates in E-Verify to verify employment eligibility for new hires. 
 
Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.

We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to recruiting@pairteam.com.

Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!</div></div>

Bilingual Case Manager (Remote Flexible, Spanish Speaking)

<div>Location: Downtown, Los Angeles CA
Position Purpose:
Under the direction of the Program Manager, the Care Team Specialist will be participating in a multi-disciplinary team, contributing to client engagement, retention, safety, and support. The position will interact with staff and clients as a care team member by building rapport and fostering a sense of community.
The Pathway Home program is an Interim Housing program that assists homeless, individuals to recover and improve their quality of life. These individuals may also suffer from mental health and substance abuse issues, sometimes causing behaviors such as yelling, cussing, and outbursts of anger. The role of each CTS staff at DTLA is to assist with safety of each residence. Each CTS during shift is expected to use our electronic tagging system to check all perimeters of the building including the top floors.
Program Population:
The Pathway Home Housing Project is a HFH funded program, operated by JWCH. The Team consist of a cohesive team of MSW, case managers, site monitors and other professionals who collaborate to provide housing and critical services to People Experiencing Homelessness (PEH) and those who have previously experienced homelessness. The clients/residents may come with behavioral and/or substance abuse issues. The program utilizes the Harm Reduction Model and we &ldquo;do whatever it takes&rdquo; to encourage success of the client.
Principal Responsibilities:<ul><li>
Performs job functions as prescribed by established policies and procedures within defined scope of education, training, and responsibilities.<ul><li>
Establish a positive rapport with clients and express a concern for their well-being.</li><li>
Demonstrate understanding and practice harm reduction methods</li><li>
Demonstrate understanding of trauma-informed care</li><li>
Demonstrate non-violent restraint methods, if needed and only as an absolute last resort</li><li>
Monitor the floors by walking corridors as assigned, and or being rotated.</li><li>
Maintain a front desk sign in/out sheet for clients, as well as visitors.</li><li>
Monitor the front lobby on a 24 hour/7-day basis.</li><li>
Search clients and/or visitor&rsquo;s belongings when they enter the building</li><li>
Assist with clients&rsquo; room searches and/or temperature control, as needed</li><li>
Assist clients with elevator access.</li><li>
Act as floor lead during fire drills and real emergencies, and as lead in performing necessary evacuations.</li><li>
Attend each shift change and contribute accordingly</li><li>
Document any client and/or client-staff incidents and submit to supervisor in a timely manner</li><li>
Answer front desk phone, as needed</li><li>
Escort clients to appointments, as needed.</li><li>
Use appropriate de-escalation techniques; call LCSW or Case Manager for assistance, as needed.</li><li>
Ability to follow all crisis protocol</li><li>
Demonstrate understanding and awareness of substance abuse and/or negative behavioral health symptoms</li><li>
Utilize agency van to transport staff to and from parking structure during dark hours and/or rain</li><li>
Provide supportive communication regarding incarceration, substance abuse, mental health, and other risk behaviors.</li><li>
Must be able to work extended shifts when emergency situations warrant in a 24 hour 7 day a week setting.</li><li>
On occasion will need to work an additional 4 hours after regular shift or 4 hours before the regular shift if situation warrants.</li><li>
Flexibility to adjust with a multiple schedule change, shift change, and days off. The work schedule is subject to change periodically based on the number of Care Team Specialists.</li><li>
Maintains the security of confidential documents.</li><li>
Work in various environments including adverse outdoor conditions such as cold, rain or heat. Must be able to work in all areas of the building.</li><li>
Work with administration to process the following:</li><li>
Performs other clerical duties</li><li>
Administrative tasks<ul><li>
Assist clients in walkers and wheelchairs if needed.</li><li>
Coordinate with HFH warehouse for all deliveries, and U.S. Mail</li></ul></li></ul></li><li>
Maintains confidentiality at all times<ul><li>
Discusses any client information only with appropriate personnel when related to the care being provided, and ensures these conversations are not near any clients</li><li>
Maintains confidentiality for all documents that contain patient/client identifier information,</li><li>
Observes and respects confidentiality of information in regards to fellow employees.</li></ul></li><li>
Responsibility and accountability for adherence to organizational and department standards and policy.<ul><li>
Observes department guidelines concerning absences and reports absences in accordance with departmental procedures,</li><li>
Self-identifies potentially unsafe systems/processes/situations and takes initiative to report to the supervisor,</li><li>
Observes department guidelines to conduct personal business during breaks and lunch hour,</li><li>
Projects a positive professional image and adheres to organizational dress code.</li><li>
Maintain shift reports and communicate with BH Team when client issues arise</li><li>
Participates in assigned staff and other meetings, and in-service training meetings</li><li>
Adhere to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.</li><li>
Participate in required safety and compliance trainings and apply learned practices in daily work activities.</li><li>
Identify, report, and help mitigate unsafe conditions, incidents, or hazards in the workplace.</li><li>
Use equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.</li><li>
Maintain awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.</li><li>
Performs other duties and tasks as may be required or assigned.</li></ul></li><li>
Physical Demands:<ul><li>
Stand or walk constantly (for up to an entire shift) on various surfaces (tile, concrete, carpet). Climb stairs, ramps, or ladders occasionally during shift.</li><li>
Must be able to kneel, squat, bend for any duration of time and run if needed.</li><li>
Occasionally bend/twist at waist/knees/neck to perform various duties, including lift or carry up to 80 lbs.</li><li>
Constant use of hands, arms, and fingers in reaching/handling/grasping while using radio, phone, notepad, writing reports and other administrative tasks.</li><li>
Adhere to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.</li><li>
Participate in required safety and compliance trainings and apply learned practices in daily work activities.</li><li>
Identify, report, and help mitigate unsafe conditions, incidents, or hazards in the workplace.</li><li>
Use equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.</li><li>
Maintain awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.</li><li>
Performs other duties and tasks as may be required or assigned.</li></ul></li><li>
Team Work and Interpersonal Skills<ul><li>
Speak effectively with staff, HFH, other agencies, and the public</li><li>
Assist with client translations as needed</li><li>
Direct and supportive communication with clients, at all times</li><li>
Demonstrates courtesy, mutual respect and compassion in dealing with others,</li><li>
Initiates and presents positive solutions to problems,</li><li>
Demonstrates effective working relations and works effectively as part of the team to facilitate the organization&rsquo;s ability to meet goals and objectives,</li><li>
Demonstrates a willingness to accommodate requirements or changing priorities in the workplace.</li></ul></li></ul>
Requirements:<ul><li>
Minimum high school diploma or equivalency</li><li>
Two years&rsquo; experience in behavioral health or social services environment.</li><li>
Previous experience working with homeless persons or population.</li><li>
Strong ability to communicate with homeless individuals who are actively participating in substance abuse and other factors related to homelessness.</li><li>
Desire to work with homeless population.</li><li>
Bilingual (English/Spanish) preferred</li><li>
Ability to assist with the collection of patient&rsquo;s valuables.</li><li>
Experience handling confidential documents and detail-oriented.</li><li>
Ability to use email, database program(s) of agency and working knowledge of word processing (Microsoft Word) and spreadsheet programs.</li><li>
Ability to communicate clearly verbally and in writing</li><li>
Effective written and oral communication and interpersonal skills with ability to deal with all levels of personnel, general public and patients in a professional and effective manner; must be able to use initiative and independent judgment within established guidelines.</li><li>
Ability to assist with emergency and behavioral health personnel with aggressive patient situations.</li><li>All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated against COVID-19.</li></ul>
Employee Benefits:
At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you&rsquo;ll enjoy competitive pay and a robust benefits package that includes:<ul><li>
Medical, Dental, Vision</li><li>
Monthly employer-sponsored allowance for assistance with health premiums.</li><li>
Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.</li><li>
Paid time off (vacation, sick leave) and 13 paid holidays.</li><li>
401(k) Safe Harbor Profit Sharing plan.</li><li>
Mileage reimbursement.</li><li>
Short- and long-term disability plans (LTD/STD).</li><li>
Life insurance policy &amp; AD&amp;D, and more!</li></ul>
Become part of a team where your work matters. Apply today and help us change lives, one patient at a time.
JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.</div>

Care Team Specialist

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