EMPLOYMENT

Title: Care Management Quality Assurance (QA)Specialist

Reports to: ECM Supportive Services Program Manager

Type: Part-time (20 - 30 hours/week), Non-Exempt

Pay: $28.50 - $36.00 / hour, depending on experience and qualifications

Location: Hybrid – United Way of Merced County Office and Virtual

Summary:

United Way of Merced County is seeking a part-time QA Specialist to support regulatory oversight, audit readiness, and quality assurance for our Enhanced Care Management (ECM) and Community Supports (CS) programs. As our programs expand across Merced and into Mariposa County, this position plays a critical role in helping us grow responsibly, ensuring compliance with Medi-Cal and Central California Alliance for Health (CCAH) standards. This is an excellent opportunity for someone with a background in healthcare compliance or quality management seeking flexible hours in a mission-driven environment.

Key Responsibilities:

• Compliance Oversight & Monitoring

  • Maintain and monitor internal compliance systems for ECM and CS programs in accordance with DHCS and CCAH guidelines.

  • Conduct routine internal audits of case documentation, service delivery, and reporting to ensure compliance with CalAIM standards.

  • Serve as lead coordinator for all CCAH and regulatory audits (preparation, response, follow-up).

  • Track corrective actions, maintain compliance logs, and escalate issues as necessary.

• Training, Support & Quality Improvement

  • Train and support care teams on documentation standards, billing readiness, and regulatory updates.

  • Develop and disseminate policy and procedure updates to reflect new guidance or compliance risks.

  • Create tools and templates for staff to improve accuracy and consistency of records and reporting.

  • Lead quality assurance initiatives in partnership with program managers and data analysts.

• Operational Coordination

  • Oversee risk assessments and support the implementation of data privacy and HIPAA protocols.

  • Coordinate with billing and program management to align compliance requirements with operational systems (e.g., EHR, closed-loop referral tools).

  • Collaborate with the 211 and ECM teams to ensure consistent intake, documentation, and referral tracking practices.

Qualifications:

• Bachelor’s degree in public health, healthcare administration, social work, related field or a Minimum 3–5 years experience in healthcare compliance, CalAIM, Medi-Cal programs, or quality assurance.

• Strong working knowledge of Enhanced Care Management and Community Supports requirements under CalAIM.

• Familiarity with audit processes and CMS/DHCS regulations.

• Experience with case management software, EHRs (e.g., eClinicalWorks, Activate Care, Pearsuite) and referral platforms preferred.

• Excellent communication, organizational, and critical thinking skills.

• Ability to train and support teams while implementing structured processes.

• Spanish or Hmong language skills are a plus.