case manager

claims specialist ii

benefits coordination specialist Jobs in Los Angeles

benefits coordination specialist

client delivery specialist Jobs in Los Angeles

client delivery specialist

clinical care coordinator Jobs in Los Angeles

clinical care coordinator

care team specialist

JWCH Institute

<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

University of Southern California

<div>Job ID REQ20173932 Category Clinical Administration</div>
 <div>The Financial Clearance Specialist IV is responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete. Documentation of accurate insurance information, knowledge of insurance plans and authorization details to optimize reimbursement from the payer are required. The Financial Specialist IV is responsible for extended understanding of division of financial responsibility to accurately adjudicate Letters of agreement to help streamline the claim management process. By securing the mutually signed Letter of agreement provides legal document that outlines the intent of both parties and will provide the supporting documentation needed for appeals for all non-contracted payers for both Professional and Hospital services. The Specialist IV must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization.
Specialist IV must also determine, communicate, and collect patient liability prior to service and attempt to collect prior balances. Specialist IV are to conduct all transactions appropriately and consistently, and complete Medicare Secondary Questionnaire accurately with the patient or patient&rsquo;s representative. Specialist IV must maintain compliance with HIPAA regulations as it pertains to the insurance processes. Specialist IV must maintain professional development by attending workshops, in-services, and webinars to remain up-to-date on insurance rules and regulations in addition to changes within the industry.
Financial Clearance Specialist IV must be proficient in hospital and professional contracted versus non-contract payers including interpretation of language specific to covered services. The specialist must also have an extended understanding of payer DOFR and authorization submission for all service scopes performed in both a hospital and professional setting.
Minimum Education:
HS Diploma or GED Required.
Minimum Experience/Knowledge:
Minimum (3) years of experience in a hospital, health plan or Physician office environment with extensive knowledge of contracted and non-contracted payers, division of financial responsibility, including the ability to articulate benefit negotiations as required when adjudicating a letter of agreement with a non-contracted payer. Proficient in submission of authorization for all service types rendered within a hospital and/or professional setting.
Knowledge of business office procedures. Knowledge of medical terminology and coding.
Knowledge of grammar, spelling, and punctuation to type patient information.
Extended understanding of payer DOFR and authorization submission for all service scopes performed in both a hospital and professional setting
Ability to read, understand, and follow oral, and written instructions and establish and maintain effective working relationships with patients, employees, and the public.
Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills. Capable of working assigned shifts, overtime when approved.
Capable of reading the policy and procedure manual and understanding information pertaining to specific job duties and the general information for all hospital employees.
Must be able to verify insurance and advanced knowledge of both CPT codes and medical terminology.
Must also be able to understand and interpret patient liability and benefits for HMOs and all payer types.
Proficient in interpreting and completing insurance verification process for all types of payers including HMO&rsquo;s Commercial, Medi Cal and Senior Plans, Medi Cal, Medicare, PPO, POS, EPO, Capitation, Military, Workman Compensation.
As part of Keck Medicine of USC, USC Verdugo Hills Hospital is the only community hospital in the Foothills area of Los Angeles backed by an academic medical center. With its 40-year legacy of personalized care from expert physicians, experienced nurses and a dedicated staff the community has come to know and trust, USC&ndash;VHH brings patients the latest medical advancements and 24/7 emergency services. Join this world-class team providing highly-specialized care, up-to-the-minute research and innovative clinical trials.
The hourly rate range for this position is $26.00 - $34.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate&rsquo;s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. 
USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying.
<div>Job ID REQ20173932 Posted Date 04/28/2026</div></div>

Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)

Serene health

<div><div>Empowering Wellness, Transforming Lives

Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.

As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.

Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.

A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!</div> 


Job Summary:

The official job title is Community Support Outreach Specialist.

The Community Support Outreach Specialist cultivates relationships with community programs, members and leaders. They develop assistance programs, offer crisis intervention for the homeless, and provide expert referrals and advocacy to help secure permanent housing, while also providing intensive support to resolve housing barriers for individuals experiencing homelessness. The Community Support Outreach Specialist also implements ongoing efforts to support members after securing housing, ensuring continued development of life skills, financial literacy, and home management skills to promote long-term stability and self-sufficiency. The program we service will include programs and centers from the community support services section below.

Responsibilities:
<ul>
<li>Perform thorough screening and assessments with individual members or families, gathering functional, environmental, financial, employment, housing, educational, and health information. The CS Outreach Specialist aid in assisting them to find and sustain housing, ultimately putting an end to their homelessness.</li>
</ul><ul><li>Develop rapport with program members to understand their housing needs, goals, strengths, and barriers, then create a feasible, sustainable Individualized Housing Support Plan based on the Community Support Assessment.</li>
</ul><ul><li>Keep the channels of communication open, and be proactive about problem-solving with individuals, interdisciplinary teams, members of Community Support, potential employers and training programs.</li>
</ul><ul><li>Offer personalized case management support to program participants that is individualized, culturally competent, family-focused, goal-driven, strengths-based and appropriate to ensure members are matched with resources considering their needs and income-generating abilities.</li>
</ul><ul><li>Provide personalized support in life skills, job preparation, and financial literacy, to guide members towards self-sufficiency by offering essential training in home care, job readiness, and budgeting.</li>
</ul><ul><li>Maintain member records, track outcomes in appropriate databases, and submit regular monthly and weekly progress reports to Supervisor.</li>
</ul><ul><li>Act as a liaison between landlords and tenants to resolve issues and prevent evictions, conduct post-housing home visits to ensure lease compliance, coordinate case conferences, consult with service teams, social workers and case managers as needed. Monitor member's progress towards agreed-upon goals.</li>
</ul><ul><li>Perform additional duties as assigned.</li>
</ul>
Community Support (CS) Services:
<ul>
<li>Housing Transition Navigation Services</li>
</ul><ul><li>Housing Tenancy and Sustaining Services</li>
</ul><ul><li>Community Transition Services/ Nursing Facility Transition to a Home</li>
</ul><ul><li>Housing Deposits</li>
</ul><ul><li>Short-Term Post-Hospitalization Housing</li>
</ul>
Education and Experience:
<ul>
<li>High school, diploma or GED is required.</li>
</ul><ul><li>Minimum of 1 year experience in case management, patient care, customer service, call center, or patient care is required.</li>
</ul>
Required Skills/Abilities:
<ul>
<li>Must have a valid California driver's license and valid vehicle insurance.</li>
</ul><ul><li>Excellent communication, interpersonal, customer service, active listening and organizational skills.</li>
</ul><ul><li>Computer skills for documentation, email and chat support.</li>
</ul><ul><li>Proficient speaking, reading, and typing abilities and possess strong proofreading skills.</li>
</ul><ul><li>Proficient skills in working independently and collaboratively in a team to provide member care.</li>
</ul><ul><li>Proficiency in multitasking, organization, financial management, planning and attention to detail is required for effectively providing care to multiple members simultaneously.</li>
</ul><ul><li>Capability to perform under circumstances of possible emotional stress and conflict, including dealing with uncooperative members and families.</li>
</ul><ul><li>Ability to utilize resources effectively for problem-solving while maintaining composure under pressure in a compassionate manner. Must have an empathetic and warm-hearted nature.</li>
</ul>
Physical Requirements:
<ul>
<li>Must be able to travel using personal vehicle to complete outreach visits. Mileage reimbursement for the use of your vehicle is at a standard rate.</li>
<li>Must successfully complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.</li>
<li>Prolonged periods of sitting at an office desk on the computer.</li>
<li>Lifting: Able to lift up to 15lbs.</li></ul><div> 
Benefits

Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:

Medical, Dental, &amp; Vision Benefits: We have various insurance options for you and your family.

Short &amp; Long-Term Disability Benefits: Protection when you need it most.

Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.

Flexible Spending Accounts: Manage your finances with flexibility.

Employee Assistance Program (EAP): Support when life throws challenges your way.

401(K): Building your financial future with us. Effective after 1 year of employment.

Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.

Paid Holidays: Quality time to enjoy celebrations.

Employee Referral Program: Share the opportunities and reap the rewards.

Company Discount Program: Enjoy savings on everyday expenses and memberships. 


Equal Employment Opportunity

Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.

Pre-Employment

Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.</div></div>

Housing Navigator

Apiari

We are looking for experienced and caring night nannies and baby nurses for overnight infant care for new parents in the greater Los Angeles area. See all our open LA jobs here: http://bit.ly/4oB0OtpExperienceCandidates must have professional experience working as a night nanny/baby nurse or infant care specialist. Experience working with colic, twins, umbilical cord and circumcision care is preferred but not required.Why Apiari We handle your marketing and back-office work so you can focus on caring for babies!<ul><li>Apply only once - we will match you to families meeting your preferences and schedule.</li><li>Secure payments before you even step out of your home.</li><li>Choose your own hourly rate.</li><li>Over 70% of family interviews lead to a booking.</li><li>Pre-screened clients, avoid scams.</li></ul>Apply here: https://web.theapiari.com/become-a-providerQualifications: - 2 references. - Min. 2 years of experience in infant care for other families in paid positions.Job Types: Part-time, ContractPay: $35.00 - $50.00 per hourBenefits:<ul><li>Flexible schedule</li></ul>Work Location: In person

Night Nanny / Baby Nurse in Los Angeles

STARS Behavioral Health Group

<div><h1 class="jobSectionHeader">Partner with us in making a positive change!</h1>
Join a team where your work truly matters. We're proud to have been certified as a Great Place to Work for 8 years by our own employees. We invite you to partner with us in our mission to improve mental healthcare.
Job Title:
Quality Assurance Specialist
Division/Program:
Los Angeles Crisis Residential Treatment (CS)
Starting Compensation:
23.00 - 24.00
Working Location:
Los Angeles CA 90033
Working Hours/Shift:
Mon - Fri 9 am to 5:30 pm
Why Join Our Team?<ul><li>
Competitive Compensation: Offering a salary that matches your skills and experience.</li><li>
Generous Time Off: Enjoy ample vacation and holiday pay.</li><li>
Comprehensive Benefits Package:</li><li><ul><li>
Employer-paid medical, dental, and vision coverage.</li><li>
Additional voluntary benefits to support your lifestyle.</li></ul></li><li>
Professional Growth Opportunities:</li><li><ul><li>
On-the-job training with access to paid CEU opportunities.</li><li>
Career development programs designed to help you grow.</li><li>
Supervision for BBS hours for AMFT, ACSW, and APCC professionals (where applicable).</li></ul></li></ul>
Employee Recognition &amp; Rewards: A culture that celebrates and rewards your hard work and dedication
What you bring to SBHG (qualifications):<ul><li>
Bachelor&rsquo;s degree in Quality Improvement/Quality Assurance, human services, psychology, or related social science field, or LVN license.</li><li>
Two (2) years of experience in the mental health field or a QA position required, preferably in in-patient setting.</li><li>
Two (2) years of experience in QA/TQM preferred.</li><li>
One (1) year experience in LACDMH clinical documentation preferred.</li><li>
Must possess a valid CA driver's license and maintain a driving record that meets the company driver eligibility policy.</li></ul><div> 
How you will make a difference:</div><div>
The Quality Assurance Specialist is responsible for the aiding the QA Manager in the execution of the quality assurance program policies and procedures for the Crisis Residential Treatment facilities. The position is responsible for auditing documentation to reconcile with billing and oversees documentation of services by staff to assure conformity with Medi-Cal, Los Angeles County DMH, other outside agencies, and internal standards and policies. The Quality Assurance Specialist manages all charts with deficiencies by processing them to the appropriate department for correction. The position is also responsible for ensuring the discharged chart is closed in the correct order and completed. Position aids the QA Manager in the oversight of the Continuous Quality Assurance program, medical records and records all CQI data. Assists in the coordination and development of CQI presentations and information gathering to execute presentations as needed. Activities performed can be time sensitive with expectations of frequent reporting of progress along with thorough oversight for accuracy. Regular interaction with all staff members, physicians, and outside agencies is expected. This position has responsibility for gathering and analyzing agency data and assisting in the agency&rsquo;s quality control, quality assurance, and quality improvement efforts. In addition, the Quality Assurance Specialist&rsquo;s duties will include but are not limited to ensuring that the chart documentation is maintained, data collection into the L.A. County data collection sites is maintained and other quality improvement tasks as assigned.<div>
Division/Program Overview:</div><div><ul><li>
16-bed facilities</li><li>
Designed for adults with mental health challenges or a recent crisis who need intensive treatment.</li><li>
24/7 programs as an alternative to urgent care or hospitalization.</li><li>
Individuals can live on-site in a homelike setting for a short term while they receive counseling and learn basic living and interpersonal skills.</li><li>
Able to receive physical and psychological evaluation, mental health, and case management services, in addition to assistance locating permanent housing.</li></ul></div></div>
Learn more about SBHG at: https://www.starsinc.com/stars-inc/
For Additional Information:
Stgarcia@starsinc.com</div>

Quality Assurance Specialist

Home Health

<div>The Corporate Clinical Documentation &amp; Chart Audit Specialist is responsible for conducting comprehensive chart audits across all long-term care (LTC) providers within the health system. This role ensures accuracy, compliance, and optimization of clinical documentation, billing practices, and regulatory adherence.

The Specialist works collaboratively with providers, facility leadership, and corporate operations to identify documentation gaps, improve provider performance, and support revenue integrity initiatives. This position operates in a hybrid capacity, requiring both in-office presence and remote work, with occasional travel to facilities as needed.

Chart Auditing &amp; Compliance
<ul>
<li>Conduct routine and targeted chart audits for LTC providers as directed by corporate leadership</li>
<li>Evaluate documentation for:</li>
<li><ul><li>Clinical accuracy and completeness</li>
<li>Regulatory compliance (federal, state, and payer-specific)</li>
<li>Billing and coding alignment</li>
<li>Medical necessity and appropriate level of service</li>
</ul></li><li>Identify trends, deficiencies, and areas of risk across providers and facilities</li></ul> 


Provider Engagement &amp; Education
<ul>
<li>Meet directly with providers (in-person or virtual) to review audit findings</li>
<li>Provide clear, professional feedback with actionable recommendations</li>
<li>Deliver ongoing education to improve documentation quality, compliance, and productivity</li>
<li>Support providers in correcting deficiencies and implementing best practices</li></ul> 


Tracking, Reporting &amp; Analytics
<ul>
<li>Maintain a comprehensive audit tracking system, including:</li>
<li><ul><li>Providers audited</li>
<li>Frequency and scope of audits</li>
<li>Findings and trends</li>
<li>Follow-up actions and outcomes</li>
</ul></li><li>Generate regular reports for corporate leadership highlighting:</li>
<li><ul><li>Compliance trends</li>
<li>Provider performance</li>
<li>Revenue impact and missed opportunities</li>
</ul></li><li>Collaborate with leadership to adjust audit focus based on organizational priorities</li></ul> 


Operational Collaboration
<ul>
<li>Partner with regional and facility leadership, including CEOs, clinic managers, and corporate teams</li>
<li>Align audit processes with system-wide goals for productivity, compliance, and revenue integrity</li>
<li>Assist in developing standardized audit tools, scorecards, and workflows</li>
<li>Participate in process improvement initiatives related to documentation and billing</li></ul> 


QUALIFICATIONS:

Education &amp; Experience
<ul>
<li>Licensed healthcare professional required (RN or APRN)</li>
<li>Minimum of 3&ndash;5 years of experience in long-term care, clinical documentation, coding, or compliance required</li>
<li>Experience with chart auditing, EMR systems, and provider documentation review required</li>
<li>Knowledge of CMS guidelines, Medicare/Medicaid regulations, and LTC billing practices strongly preferred</li></ul> 


Skills &amp; Competencies
<ul>
<li>Strong analytical and critical thinking skills</li>
<li>Excellent communication skills with the ability to provide constructive, professional feedback</li>
<li>High level of organization and ability to manage multiple audits and timelines</li>
<li>Proficiency in data tracking and reporting (Excel preferred)</li>
<li>Ability to work independently while collaborating across multiple facilities</li></ul> 


Work Environment &amp; Expectations
<ul>
<li>Hybrid role: combination of in-office and remote work</li>
<li>Occasional travel to LTC facilities across the system</li>
<li>Regular interaction with providers and executive leadership</li>
<li>High level of confidentiality and professionalism required</li></ul> 


Key Performance Indicators (KPIs)
<ul>
<li>Audit completion rates and timeliness</li>
<li>Improvement in provider documentation quality</li>
<li>Reduction in compliance risks and deficiencies</li>
<li>Measurable improvement in revenue capture / reduction in missed opportunities</li>
<li>Provider engagement and follow-through on recommendations</li></ul> 


Reporting Structure
<ul>
<li>Reports to: Vice President of Long-Term Care Operations</li>
<li>Works closely with: Corporate compliance, finance, and facility leadership teams (CEOs, Regional LTC Directors and office managers)</li></ul></div>

Corporate Clinical Documentation & Chart Audit Specialist (RN/APRN)– Long-Term Care

United Medical Imaging Healthcare

<div><div>Human Resource Specialist - LOA &amp; Employee Relations (West LA)<div>
Reputable healthcare company in Southern California is looking for a Human Resource Specialist to assist with HR Functions and company employees in areas of payroll, time and attendance, benefits coordination, leaves of absence, company policies, and employee relations. 
 
Job Responsibilities: 
 
<ul><li>Work with Managers/Supervisors on a daily and weekly basis to discuss changes, issues and openings and to ensure all workplace accidents, injuries, leaves, illnesses etc. are reported promptly.</li><li>Advise senior management on human resources issues, including policies, disciplinary actions, employee relations issues, performance evaluations, compensation, and terminations.</li><li>Superior knowledge of labor laws as they pertain to FMLA, CFRA, ADA, Worker's Compensation and other state and federal leave laws as well as best practice for employee leave communication and process improvement</li><li>Assist employees with leaves of absence while determining impact on employment status. Administer all leave of absence requests and paperwork for medical, disability and FMLA leaves.</li><li>Determine leave eligibility, calculate duration of leave and monitor activity during leave to ensure employee does not exceed allowed time. Ensure that employee insurance payments are made while on leave, if necessary.</li><li>Strong knowledge of benefits administration, as well as experience in Open Enrollment, employment and labor laws</li></ul></div><ul><li>
Lead investigations into complaints of potential unlawful behavior, such as harassment, discrimination and retaliation.</li><li>
In connection with the internal investigation process, conducts the following in-depth meetings:<ul><li>
Claimant intakes</li><li>
Witness interviews</li><li>
Response meetings with alleged wrong-doers</li><li>
Conclusion meetings with the claimant, respondent, and other relevant parties.</li></ul></li><li>
Gathers, interprets, and analyzes data</li><li>
Composes correspondence and other highly confidential documents such as investigation recaps, corroboration charts, action plans, conclusion talking points, executive scripts, etc.</li><li>
Present oral and/or written comprehensive updates regarding findings and investigation status</li><li>
Based on findings make recommendations with regard to disciplinary measures and development opportunities.</li></ul><div>
Required Skills: 
 
<ul><li>Bachelor's Degree in Business Management, Human Resources or a related area.</li><li>Minimum 2 years of HR experience required</li><li>Experience in health care industry is desired.</li><li>Excellent oral and written communications skills, including the ability to clearly and concisely answer questions and convey information to employees &amp; management team.</li><li>Ability to work independently and self- initiator.</li><li>Ideal candidate has a people personality and can build bonds and connections with employees and candidates</li><li>Effective time management, multi-tasking ad organization skills, including ability to prioritize workload to meet key deadlines.</li></ul></div><ul><li>
Must be able to handle multiple projects simultaneously.</li><li>
Must have excellent follow-through and a strong sense of urgency.</li><li>
Must be able to research and analyze data and findings</li><li>
Must be able to be tactful yet assertive when addressing employment issues and concerns.</li><li>
Must be able to handle difficult/highly emotional personalities.</li></ul> 
Competitive Salary, based on education and experience. 
Competitive benefit program, including Medical, Dental, Vision, Life Insurance, 401K, PTO, Holidays</div></div>

Human Resources Specialist & Employee Relations

Explore 625+ Care team specialist in Los Angeles this May. Find roles across top companies and apply now to boost your career.