CalAIM QA Manager

WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.

Join us in our mission!

SUMMARY

The CalAIM Quality Assurance Manager oversees day-to-day quality assurance operations across Titanium CalAIM programs, including Enhanced Care Management, Community Supports, and the Health Home Program. Reporting to the Director of Education and Quality Assurance, this role supervises the Quality Assurance Specialist team, manages completion of the internal audit schedule set by the Director, and is accountable for the accuracy, consistency, and timeliness of completed audits.

The Quality Assurance Manager executes the audit framework and documentation standards established by the Director, supports preparation for health plan audits, and carries out assigned corrective actions through completion. This is a working manager role that balances direct audit work with team supervision, calibration, and staff development.

WHERE YOU’LL WORK

This position is remote. Standard business hours are Monday through Friday from 8:00 am to 5:00 pm. 

WHAT YOU’LL DO

• Manage completion of the internal audit schedule set by the Director, ensuring monthly and quarterly review targets are met on time across all assigned managed care plan contracts
• Assign audit volume across the Quality Assurance Specialist team, monitor progress against the schedule, and reallocate workload as needed to stay on target
• Notify the Director in advance when scheduled targets are at risk, with the cause and a proposed recovery plan
• Conduct and oversee chart audits evaluating documentation accuracy, completeness, timeliness, and alignment with CalAIM and managed care plan requirements
• Review completed audits for scoring accuracy and inter-rater consistency and resolve discrepancies before findings are released to the field
• Lead recurring calibration sessions to keep scoring and interpretation consistent across all reviewers
• Apply established audit tools, scoring rubrics, correction timelines, and escalation protocols consistently, and flag indicators that require revision to the Director
• Maintain assigned audit tools and tracking documents in SharePoint, following established version control practices

Audit Readiness & Compliance

• Support preparation for managed care plan audits, including chart identification, documentation review, and assembly of requested files
• Complete assigned corrective action steps within established timelines and provide supporting documentation of completion
• Conduct follow-up review to verify that corrective actions have been implemented and are holding
• Perform routine monitoring and spot checks to identify documentation risk in advance of external review
• Maintain organized, audit-ready evidence files for completed internal audits
• Escalate compliance risk, adverse findings, and potential contract issues to the Director promptly

Team Leadership & Development

• Supervise, coach, and develop the Quality Assurance Specialist team, including onboarding, workload assignment, and day-to-day support
• Conduct regular one-on-one check-ins and complete performance reviews in accordance with company timelines
• Monitor auditor productivity and review quality, and address performance concerns promptly and constructively
• Identify skill gaps within the team and communicate training needs to the Director and the Education team
• Support a team culture that emphasizes accuracy, accountability, and continuous improvement

Tracking & Reporting

• Maintain quality assurance trackers and dashboards and ensure data accuracy at the source
• Prepare monthly and quarterly audit reporting for the Director, including completion rates, scoring results, auditor productivity, and care coordinator performance
• Summarize recurring findings and documentation trends and surface them to the Director for action
• Maintain audit tracking workflows and report technical issues or automation failures to the Director

Collaboration & Follow-Up

• Communicate audit findings to supervisors and program managers and confirm that corrections are completed within required timelines
• Deliver findings-based feedback and retraining to Lead Care Managers, Care Coordinators, and outreach staff
• Share audit findings with the Education team so that training content and job aids can be updated
• Provide input on job aids and documentation guidance based on trends observed during review
• Perform other duties and projects as assigned

WHO YOU ARE

• Strong attention to detail with the ability to review documentation for accuracy, completeness, and compliance with program standards
• Excellent written and verbal communication skills, with the ability to clearly document audit findings and communicate feedback to staff and leadership
• Analytical thinking and problem-solving skills to identify documentation trends, workflow gaps, and opportunities for improvement
• Ability to interpret program requirements, policies, and health plan guidance and apply them during documentation review
• Strong organizational and time management skills, with the ability to manage multiple audits and competing priorities
  
• Strong written communication skills, particularly in audit findings, corrective action documentation, and health plan responses
• Ability to manage competing deadlines across multiple plan contracts with minimal supervision

Sensory Requirements

• Fluent in English (written and verbal)
  
• Adequate hearing and vision (with corrective devices if necessary) to conduct assessments and documentation
  
• Ability to identify problems and use logic and related information to develop and implement solutions
• Excellent organizational skills and attention to detail
• Commitment to maintaining patient confidentiality and adhering to ethical standards in healthcare practice
• Ability to communicate clearly and professionally through virtual meeting platforms and written communication tools

Physical Activity

• Must be able to remain in a stationary position for extended periods while reviewing documentation, completing chart audits, and preparing reports
• Occasionally required to move or carry materials up to 15 pounds
  

Environmental Conditions 

• Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures
• This position is primarily remote, with occasional travel (less than 10%) for meetings, trainings, or organizational events

Technology Use

• Ability to type for extended periods
• Competent with computers, email, virtual platforms, and Microsoft Office based programs. Proficiency in Microsoft Office applications including Excel, Teams, and SharePoint for tracking, reporting, and collaboration
• Comfort working within electronic health record systems to review member documentation and service records
• Consistently operates a computer and standard office equipment in a home-office or remote work environment
• Ability to work across multiple digital systems, including electronic health records, reporting tools, and collaboration platforms

WHAT YOU’LL NEED

• Associate or bachelor’s degree in public health, social work, healthcare administration, human services, or another related field
• Minimum 3+ years of experience in a Medi-Cal program environment, such as Enhanced Care Management, Community Supports, Health Homes, care coordination, or case management
• Minimum 1+ year of experience supervising, leading, or formally mentoring staff
• Demonstrated experience conducting chart audits or documentation reviews and interpreting health plan or regulatory documentation standards
• Working knowledge of CalAIM program requirements and managed care plan documentation expectations
• Experience with eClinicalWorks, Power BI, or Power Automate 
  
• Distraction-free home workspace with a secure internet connection

WHAT YOU’LL ENJOY

• Make an impact: an organization who cares about its employees, communities, and the future of healthcare
• Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
• Growth: opportunities to develop and grow your career with us
• Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business
• Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, reproductive loss, and therapy
• Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
• Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
• Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
• Flexible Spending, Health Savings & Dependent Care Accounts
• Life/AD&D insurance funded 100% by Titanium Healthcare
• Supplemental Short-Term Disability

• Employee Assistance Programs
• Protect your pet(s) with Pet Insurance
• 401(k) plan 

EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.

Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.