Lead Care Specialist (CalAIM)

Position Summary:

New Beginnings is seeking a qualified and experienced CalAIM Lead Care Specialist to provide comprehensive support for the Enhanced Care Management (ECM) and Community Supports (CS) programs under our CalAIM initiative. The CalAIM Lead Care Specialist will provide support in conjunction with the Authorization Specialist and Billing Specialist to ensure that all ECM and CS activities are effectively managed, including utilization management, member assignment, and reporting. This role requires a deep understanding of Medi-Cal and CalAIM processes, and the ability to optimize service delivery while ensuring compliance with all relevant regulations and standards.

Key Responsibilities:

● Program Oversight: Provide oversight for all ECM activities, including utilization management, member assignment, and reporting. Ensure that all program deliverables are met and that ECM and Community Supports services are delivered effectively and efficiently.

● Regulatory Compliance: Stay current with state and federal regulations related to CalAIM, Medi-Cal, and ECM/CS. Ensure that all activities and documentation meet regulatory requirements and that the program remains in full compliance.

● Care Management: Track and ensure the timely completion of ECM assessments and care plans. Oversee the documentation of Community Supports services, ensuring that all records are accurate and complete.

● Provider Oversight: Provide trainings and, with other members of the CalAIM team, be the go-to support for general staff that need help understanding CalAIM forms, the billing process, and following care plans. Provide oversight of ECM and Community Supports service provision by program staff in conjunction with Program Directors, ensuring that core services are delivered as required. Work closely with providers and Program Directors to optimize service delivery and address any issues or concerns that arise.

● Process Optimization: Optimize internal and external CalAIM processes, making recommendations for improvements to enhance service delivery and program efficiency. Ensure processes are streamlined for Caseworkers while still aligning with CalAIM guidelines.

● Documentation and Reporting: Review case notes for all claims made and related documentation in the Health Management Information System (HMIS). Assist in tracking authorizations and reauthorizations and assist with claims reviews as necessary to ensure accurate and timely billing.

● Quality Improvement: Participate in internal and external meetings as necessary. Provide suggestions for quality improvement initiatives to enhance the effectiveness of ECM and Community Supports programs.

● Additional Duties: Perform other duties as assigned by the Program Director, Homeless Services Director and Executive Director to support the successful implementation and operation of the CalAIM initiative.

Qualifications:

● Education:

o Bachelor’s degree in social work, psychology, counseling, nursing, public health, business or a related field.

● Experience:

o Minimum of 1-2 years of experience working with Medi-Cal/CenCal systems management.

o Experience in managing care coordination tasks.

o Proven track record in implementing CalAIM or similar healthcare programs preferred.

o Familiarity with utilization management, provider oversight, and billing processes in a healthcare setting.

● Skills and Competencies:

o Strong Team Player with the ability to work cohesively in a team environment.

o In-depth knowledge of Medi-Cal, CalAIM, and the needs of the Medi-Cal member population.

o Excellent organizational and time-management skills.

o Ability to analyze complex data, review documentation, and track program performance.

o Strong communication skills, both written and verbal, with the ability to work collaboratively with a variety of stakeholders.

o Proficiency in HMIS and other care management software preferred but not required.

o Familiar with client intake and assessments

o Ability to work unsupervised, in the field for part of shift with a commitment to issues related to ending homelessness through employment

o Ability to set priorities, meet deadlines and follow through

o Excellent written and oral communication skills

o Strong organizational and time management skills.

o High level of accuracy and attention to detail.

o Ability to multitask and prioritize.

o Excellent administrative skills.

o Strong computer skills and knowledge of databases and relevant software programs.

o Ability to maintain professional conduct, attitude and appearance at all times

o Proficiency in PC computer systems and Microsoft Office, including the ability to perform word processing, data entry, and other tasks at a computer workstation

o Adhere to laws regarding confidentiality and reporting requirements; maintain knowledge of current HIPAA certification standards

o Willingness to travel: Driver's License: A valid driver's license and an operating insured, registered vehicle is required at the time of application. A valid California Class C Driver's License is required at the time of appointment.

Work Environment:

This is a full-time, on-site position located at New Beginnings’ main office in Santa Barbara, with travel up to Mid and North County offices as needed. The CalAIM Lead Care Specialist will work closely with the Homeless Services Director, our CalAIM team, ECM and Community Supports providers, our data analyst, individual program Directors, and various internal departments to ensure the successful implementation of CalAIM initiatives.

Work hours are Monday - Friday, 9-6 although there may be occasional nighttime and weekend hours to attend community events or attend to emergent client and administrative needs. Starting salary is $28-$32 per hour DOE with benefits as outlined below. Position begins asap.

Application Process:

Interested candidates are encouraged to submit a resume, cover letter and a list of three professional references to hr@sbnbcc.org. If we feel you are a good match for the position, you will be contacted to schedule an interview.

Benefits:

We believe our team does its best work when it feels supported—both inside and outside of work. That’s why we offer a comprehensive benefits package that takes care of your health, your future, and your peace of mind:

Medical, dental, and vision insurance to keep you and your family healthy

Employee-sponsored AFLAC supplemental plans for added financial protection when you need it most

Employer 403(b) contributions and matching to help you build a strong financial future

Employee Assistance Program (EAP) offering confidential support and resources for life’s challenges

Generous paid time off to rest, recharge, and focus on what matters most

Join a team that values balance, growth, and well-being—because when you thrive, we all succeed.

Additional Information:

All qualified applicants will receive consideration for employment without regard to race; color; ancestry; national origin; religion/creed; sex/sexual orientation; gender; gender identity/expression, transition; political affiliation or beliefs; disability, medical condition, generic information, marital status; military/veteran status; pregnancy and conditions related thereto.; or any other characteristic protected by law (as defined by the California Fair Employment and Housing Act Government Code Section 12900-12996), except where such discrimination is based on a bona fide occupational qualification.