Quality Assurance (QA) Manager - CalAIM ECM & Community Supports

Quality Assurance (QA) Manager – CalAIM ECM & Community Supports Pay Rate: $34.00–$36.00/hrPosition Type: Special Projects – 12-Month W2 Contract(renewal based on performance, project continuation, and health plan needs)Schedule: 9:00 AM – 5:30 PM PST, Monday–FridayModel: Hybrid Field-Forward (some onsite audits, coaching sessions, and partner meetings)Star Nursing Services is hiring a Quality Assurance (QA) Manager to support statewide CalAIM Enhanced Care Management (ECM) and Community Supports quality review operations. This role focuses on documentation accuracy, DHCS compliance, Managed Care Plan (MCP) requirements, audit readiness, reporting, and staff coaching.The QA Manager plays a critical role in ensuring quality, compliance, and performance across multiple counties and service lines. What You’ll Do• Conduct comprehensive quality audits of ECM and Community Supports documentation• Review assessments, care plans, progress notes, housing service documentation, transitions of care, and outreach logs• Identify trends, gaps, and compliance risks; develop corrective actions and quality improvement plans• Support DHCS and MCP audits, desk reviews, and quality monitoring processes• Assist with CAP (Corrective Action Plan) development, implementation, and follow-up• Collaborate with ECM and Community Supports Directors to strengthen workflows and reduce deficiencies• Provide 1:1 coaching and team training for Care Managers, Lead Care Managers, Housing Navigators, and field teams• Ensure documentation meets DHCS policy requirements, MCP contract standards, and CalAIM timelines• Monitor EMR usage, workflow adherence, and accuracy of service coding• Maintain internal QA logs, audit findings trackers, and weekly/monthly reporting• Participate in health plan meetings when required to review quality trends and improvement needs• Escalate serious quality issues or risk indicators to leadership promptly• Support readiness for onboarding new health plans, new counties, and additional CalAIM services Field ExpectationsThis is a hybrid position with field-forward responsibilities:• Occasional in-person coaching sessions with staff• In-person audit support and site visits when required• Onsite attendance for health plan meetings, trainings, or QA reviews• Remote work reserved for documentation review, reporting, and coaching preparation Required Qualifications• Care/Case Management experience required• Minimum 2–3 years of QA, compliance, auditing, or supervisory experience in:– CalAIM ECM– Community Supports– Social Services– Public Health– Health Plan operations• Strong knowledge of:– CalAIM requirements– Enhanced Care Management (ECM)– Community Supports (housing & non-housing)– Medi-Cal MCP documentation standards• Experience with appeals, grievances, quality reviews, and CAP execution• High attention to detail and strong analytical skills• Ability to train and coach staff on documentation improvements• Experience reviewing EMR documentation for accuracy and compliance• Strong written communication skills, clarity, and professional tone Transportation Requirements• Unrestricted active California driver’s license• Valid auto insurance• Current vehicle registration• Reliable vehicle for occasional field or partner site travel Technology Requirements• Intermediate proficiency in:– Microsoft SharePoint– Excel– Word– Teams– Adobe applications• EMR/EHR proficiency required• Ability to review large volumes of documentation electronically Minimum PC SpecificationsWindows 10 or higherMinimum 8GB RAM (16GB recommended)Intel i5 / AMD Ryzen 5 or higher256GB SSD or largerChromebooks not allowedScreenshot of PC specifications required for interview Education• BA/BS preferred in Public Health, Social Work, Healthcare Administration, Human Services, or related field• Equivalent experience accepted Why This Role MattersThe QA Manager ensures the accuracy, integrity, and compliance of all CalAIM documentation. High-quality documentation protects Star Nursing, improves member outcomes, and ensures renewal and stability of our health plan partnerships.For additional information on CalAIM, please visit:https://www.dhcs.ca.gov/calaim Company DescriptionStar Nursing is a Joint Commission Certified healthcare staffing agency with thousands of nationwide opportunities. Travel, direct hire, and temporary positions available, highest rates in the industry!

Salary : $34 - $36