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HealthRIGHT 360

Clinical Specialist, ECM

Santa Ana, CA, USPosted 3 weeks ago
onsite

Job Description

This is a hybrid role, requiring regular in‑person work at one of our primary worksites in San Francisco (SF), Los Angeles (LA), Orange County (OC), or San Diego (SD). Candidates must be based within reasonable commuting distance of one of these locations and able to work onsite as needed.   JOB SUMMARY   HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic barriers to healthcare and promote health equity for all. We offer a wide range of services, including mental health care, residential and outpatient substance use treatment, and primary health services. Additionally, we provide transitional support for individuals re-entering the community after involvement in the criminal justice system. By integrating physical and behavioral health, we empower individuals to overcome challenges by addressing social determinants of health, fostering resilience, and facilitating recovery.    CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and payment reforms across the Medi-Cal program. A key feature of CalAIM is the statewide introduction of an Enhanced Care Management (ECM) benefit and a menu of Community Supports, which, at the option of a Managed Care Plan (MCP), publicly funded health insurance plans for low-income citizens, can address the clinical and non-clinical needs of Populations of Focus with the most complex medical and social needs.      The Clinical Specialist supports HealthRIGHT 360’s ECM programs by providing clinical oversight, consultation, and guidance for complex member cases. This role ensures care is person-centered, evidence-based, and aligned with regulatory requirements while supporting care teams in coordinating behavioral health, physical health, and community-based services for high-need Medi-Cal members.    KEY RESPONSIBILITIES   Clinical Strategy   Support development and implementation of clinical strategies aligned with program goals.   Integrate evidence-based practices into care delivery.   Evaluate and recommend clinical models, care pathways, and best practices.   Partner with leadership on quality improvement initiatives.    Clinical Oversight  Provide clinical oversight and guidance to the ECM team.   Ensure clinical interventions are effective, appropriate, and efficient.   Review Comprehensive Assessments, additional assessments, and Care Plans for quality and compliance.   Ensure adherence to local, state, and federal regulations.   Clinical Support and Training  Develop and deliver trainings on clinical topics, care coordination, and student engagement.   Provide ongoing consultation and support to staff, including complex case debriefs.   Offer clinical and administrative guidance as needed.   Support escalated or high-acuity ECM member cases.   Trainings may be delivered in-person, virtually, in field-based settings, or as otherwise assigned.   Administration and Other Duties  Serve as a clinical liaison between ECM, providers, and community resources.   Participate in multidisciplinary teams, committees, and ICT meetings.   Contribute to care plan development and updates.   Maintain timely and accurate documentation in EHR/provider systems (within 24 hours).   Attend required meetings, trainings, and workshops.  Complete assigned trainings in a timely manner.    And perform other duties as assigned.         QUALIFICATIONS    Credentials  Master’s degree in Psychology, Counseling, Social Work, Marriage and Family Therapy, or related field from an accredited graduate school. Valid licensure from the California Board of Behavioral Sciences as an LMFT, LPCC, or LCSW.   Valid First Aid and CPR certification or ability to obtain within 30 days of hire.  Valid California Driver’s License and access to registered and insured transportation preferred.  Experience   Minimum of 3 years clinical experience, with at least 1 year in care management, population health, or related field.   Experience working with clients experiencing acute withdrawal from substances.   Previous Clinical experience working with individuals recently released from jail or prison or experiencing homelessness.  Experience working with Medi-Cal, Medi-Care, and private medical insurance plans preferred.  Experience providing trauma-informed services preferred.        

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Clinical Specialist, ECM at HealthRIGHT 360 | Renata