NEOGOV · 10 hours ago
Medi-Cal & CalAIM Program Specialist
Orange, CA
Full-time
Hybrid
Entry, Mid Level
$56K/yr - $84K/yr
1+ years expCalOptima is a mission-driven community-based organization that serves member health with excellence and dignity. They are seeking a Medi-Cal & CalAIM Program Specialist to provide comprehensive support for CalOptima Health's Street Medicine Program and Justice-Involved Reentry Initiative, focusing on administrative responsibilities, service coordination, and program monitoring to enhance member outcomes.
GovTechHuman ResourcesInformation TechnologySoftware
Responsibilities
Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
Assists the department in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department
Works with cross-functional teams to support the implementation, monitoring and evaluation of CalAIM services, activities and reports
Assists in developing and updating program materials that support effective program implementation
Assists with developing auditing tools, conducting audits of contracted providers and providing recommendations for compliance and quality improvement plans
Collects and analyzes data related to the health outcomes and service utilization of JI members and prepares reports for management and stakeholders on the impact of programs and services
Communicates with external partners, providers and stakeholders to ensure accurate program updates, reminders and relevant information are distributed in a timely manner
Coordinates regulatory reporting for assigned programs and prepares memos, documents, reports and forms as needed
Enters data into CalOptima Connect portal and other CalOptima Health information systems as needed
Collaborates with CalOptima Health's Facilities and Information Technology departments to support the needs of the Street Medicine Program
Prepares monthly and quarterly data related to the Street Medicine and JI initiatives
Provides support for Care Traffic Control, including training new users, monitoring tickets, tracking weekly data uploads and auditing the system
Supports correctional facilities, pre-release care managers and enhanced care management (ECM) providers to coordinate care for members as needed
Provides information on topics, including pre-release care manager and ECM provider assignment, managed care plan (MCP) policy pertaining to the JI population of focus (POF), prior authorization, MCP services such as community supports and non-emergency medical transportation, primary care provider (PCP) assignment and network providers
Ensures smooth assignment of ECM providers to eligible JI members
Supports the department in the training and monitoring of JI ECM providers
Monitors activities of JI ECM providers to ensure compliance with policy guide
Stays updated about Department of Health Care Services (DHCS) CalAIM program requirements and outcomes
Supports the achievement of CalOptima Health's vision and goals for its Street Medicine Program as defined in the Street Medicine Operations Manual
Coordinates department calendars and schedules as assigned, including scheduling appointments, preparing meeting materials, taking minutes, coordinating travel, meetings and events, evaluating needs and scheduling meeting arrangements
Provides administrative support for specific and/or ongoing projects, such as generating reports, collecting data and maintaining project tracking logs
Maintains confidential and sensitive information and files regarding management projects, policies and personnel while ensuring appropriate follow-up
Responds to Street Medicine referral calls and directs inquiries to the appropriate provider, while offering support via phone and electronic communication during regular business hours. Ensures all incoming questions are addressed within one business day
Coordinates and monitors email communication with external partners for the JI initiative
Completes other projects and duties as assigned
Qualification
Required
Bachelor's degree in health policy, health care economics, public policy, public health, sociology, psychology, social work or a related field PLUS 1 year of experience in program development, implementation and operations or related experience in a managed health care organization required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying
Have access to means of transportation for work away from the primary office approximately 20% of the time required
Preferred
3 years of experience working with health care delivery systems and/or in a public agency/organization serving Medi-Cal, Medicare or any other under resourced populations
2 years of experience working with community-based organizations
Bilingual in English and one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese)
Benefits
CalPERS pension program and additional retirement packages.
A generous PTO program
A quality work life balance
Various wellness programs
Tuition Reimbursement
Professional development opportunities
Career development opportunities
Flexible scheduling
Company
NEOGOV
NEOGOV is the leading provider of workforce management software uniquely designed for the public sector, education, and public safety.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$700MKey Investors
Warburg Pincus
2025-07-28Secondary Market· $700M
2025-07-28Acquired
2021-06-02Private Equity
Leadership Team
Shane Evangelist
CEO
Brandon McDonald
Head Of Marketing
Recent News
Canada NewsWire
2025-11-14
2025-11-14
Government Technology US
2025-10-31
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