Job Type
Full-time
Description
Position SummaryWEA is hiring a Director of CalAIM Programs to lead every CalAIM program across our Southern California operations in Los Angeles, San Bernardino, San Diego, and Riverside counties. The Director owns Enhanced Care Management (ECM) across all six populations of focus we serve, Community Supports, and our other CalAIM programs, and oversees the Community Health Access Center, WEA's call center. The Director reports to the Chief Operating Officer and leads the CalAIM Program Managers across all Southern California locations.
This is a 100% field-based role. The Director works where our care teams work: on the street with outreach teams, at clinic and partner sites, in hospitals and correctional facilities, and with managed care plan partners across the region.
Location: Field-based across Los Angeles, San Bernardino, San Diego, and Riverside counties, with daily travel between sites.
Key ResponsibilitiesCalAIM Program Leadership- Lead all CalAIM programs across Southern California, including ECM, Community Supports, and other CalAIM programs, in line with DHCS policy guides, regulatory requirements, and managed care plan contracts.
- Direct ECM services across the six populations of focus WEA serves: individuals and families experiencing homelessness; adults at risk for institutionalization; high utilizers of emergency and inpatient care; adults with serious mental illness or substance use disorder; individuals transitioning from incarceration; and the birth equity population.
- Build and maintain workflows and protocols for each population of focus, co-developed with the Medical Director and Nursing Director.
- Ensure care teams follow WEA's care team model of lead care managers, RN team leaders, behavioral health care managers, community health workers, and care coordinators, at the staffing ratios set for each contract.
- Oversee the quality of assessments and care plans so every member receives coordinated, whole-person care and has an assigned primary care provider.
- Integrate ECM with WEA's street medicine teams for members experiencing homelessness.
- Coordinate with correctional facilities, probation, and managed care plans on pre-release and post-release handoffs for justice-involved members.
- Coordinate with perinatal providers and doulas to support members in the birth equity population.
Community Health Access Center- Oversee the Community Health Access Center, including telephonic outreach, ECM enrollment, scheduling, member follow-up, and re-engagement of members care teams cannot reach.
- Set performance standards for the center and track them, including outreach attempts, enrollment conversion, response times, and documentation quality.
- Make sure call scripts, workflows, and documentation meet managed care plan outreach requirements and HIPAA.
- Connect the center's work to field teams so every enrolled member is handed off to a lead care manager without delay.
Managed Care Plan Partnerships- Serve as WEA's lead operational contact for managed care plan partners across Southern California, including IEHP, L.A. Care, Health Net, Molina, and Anthem.
- Manage referrals, authorizations, contract deliverables, and required reports for each plan.
- Lead plan audits, oversight reviews, and corrective action plans.
- Identify opportunities to add populations of focus, Community Supports, and service areas with current and new plan partners.
Operations, Billing, and Quality- Own the CalAIM program budget for Southern California in partnership with the Chief Operating Officer and Finance.
- Ensure accurate, timely documentation that supports billing, and work with Finance to resolve claim and encounter issues.
- Track program data by county, plan, and population of focus, including enrollment, engagement, caseloads, and outcomes, and brief the COO on results.
- Lead quality improvement across CalAIM programs, including emergency department and hospital use, follow-up after discharge, and care plan completion.
- Recommend and implement goals, policies, and procedures that improve efficiency and service quality.
People Leadership- Directly supervise the CalAIM Program Managers across all Southern California locations and the leadership of the Community Health Access Center.
- Partner with Practice Managers to support and strengthen CalAIM program initiatives at each site.
- Lead hiring, onboarding, training, performance management, and staff development, so every program is staffed with qualified employees.
- Build a field culture that is trauma-informed, culturally responsive, and accountable for results.
Work EnvironmentThis position is 100% field-based. Work takes place in outdoor street-based settings, encampments, shelters, clinics, hospitals, correctional facilities, and partner sites across Los Angeles, San Bernardino, San Diego, and Riverside counties, with daily regional travel.
Employment ConditionsEmployment is contingent on successful completion of a background check following a conditional offer of employment and on meeting WEA's Occupational Health Clearance requirements. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the California Fair Chance Act and applicable local fair chance ordinances.
Third-Party Recruiting NoticeWellness Equity Alliance does not currently accept unsolicited resumes or candidate submissions from third-party recruiters, staffing agencies, search firms, or other external recruiting vendors. Please do not contact hiring managers or members of our People & Culture team regarding recruitment services unless you have an existing agreement with WEA.
Any unsolicited resumes or candidate information submitted without a current, authorized agreement will be considered the property of Wellness Equity Alliance, and no placement fee or other compensation will be owed in connection with any resulting hire.
Compensation
$115,000 - $145,000 per year. Candidates with an active California clinical license may be placed in the higher end of the range. This position has potential for productivity incentives and equity.
Requirements
Minimum Qualifications- Bachelor's degree in social work, public health, healthcare administration, or a related field. Experience can be substituted for education on a year-for-year basis.
- Five (5) or more years of care management or population health experience, including at least three (3) years managing managers.
- Direct experience running CalAIM ECM or Community Supports programs with Medi-Cal managed care plans.
- Experience leading programs across multiple sites or counties.
- Valid California driver's license, reliable transportation, and ability to travel daily across Southern California.
Essential Skills- In-depth knowledge of the ECM and Community Supports policy guides and related regulatory requirements.
- Strong leadership and team management skills, with the ability to inspire and motivate field staff.
- Proficiency in data analysis and program evaluation to drive continuous improvement.
- Excellent communication and collaboration skills with diverse stakeholders, including plans, counties, hospitals, and community partners.
- Ability to manage a budget and billing-driven operations.
Preferred Qualifications- Master's degree in social work, public health, healthcare administration, or a related field.
- Active California clinical license, such as LCSW, LMFT, or RN.
- Experience managing a call center or telephonic outreach team.
- Experience with the CalAIM Justice-Involved Reentry Initiative or reentry programs.
- Experience serving people experiencing homelessness, including street medicine.
- Bilingual in English and Spanish.
Salary Description
$115,000 - $145,000 per year + incentives/equity
