ECM Administrative/Quality Assurance Specialist - Full Time - 40 Hours/Week (CA2)

ECM Administrative/Quality Assurance Specialist - Full Time - 40 Hours/Week (CA2)

Salary Range $34.56 - $36.11 Hourly Position Type Full Time

Description

At Episcopal Community Services (ECS), employees work with participants who may be experiencing homelessness, behavioral health conditions, substance use challenges, and other difficult life circumstances. While this work is meaningful and mission-driven, it can at times be stressful, demanding, or unpredictable. Employees are expected to exercise sound judgment, remain aware of their surroundings, follow established safety, communication, and de-escalation procedures, participate in all required trainings, and promptly report incidents, threats, injuries, or unsafe conditions, in accordance with ECS policies and procedures.

This position is a fully onsite, client-facing role that requires in-person interaction and direct service delivery to participants at ECS program locations. Due to the essential nature of the duties and the need for consistent in-person engagement with clients, remote work or work-from-home arrangements are not available for this position.

External Candidates: $34.56 - $35.08/Hour

Internal Candidates: $35.59 - $36.11/Hour Based on Longevity

The Enhanced Care Management (ECM), Community Supports (CS), and Community Health Worker (CHW) programs provide comprehensive, person centered care coordination for individuals with complex medical, behavioral, and social needs. Services are delivered in the community where clients live, work, and frequent, focusing on improving health outcomes, increasing stability, reducing unnecessary hospitalizations, and strengthening access to housing, mental health, substance use treatment, and other essential resources.

This position serves as a key support to the CalAIM team, maintaining program documentation with accuracy, organization, and compliance of program operations across the CalAIM service continuum. The role is responsible for maintaining client records, tracking and validating required documentation, supporting billing and reporting processes, and ensuring all records and workflows meet DHCS and Managed Care Plan (MCP) requirements. Through strong organization, attention to detail, and proactive coordination, this position helps ensure efficient daily operations, consistent documentation practices, and high-quality service delivery.

PRIMARY DUTIES AND RESPONSIBILITIES:

• Handles program documentation, billing support, and compliance activities related to ECM, CS, and CHW services to support care teams and leadership.
• Ensures the timeliness, quality, and accuracy of encounter documentation, outreach attempts, assessments, care plans, ICT notes, transitions of care, and other required elements in accordance with DHCS and MCP guidelines.
• Verifies the presence and completeness of all required ECM/CS documentation and maintains proper submission and storage of electronic client records.
• Reviews documentation for errors, duplications, or issues that may result in encounter rejections or claim denials; collaborates with staff to resolve discrepancies.
• Supports monthly billing processes by preparing encounter summaries, reconciling documentation, and coordinating with internal departments to ensure accurate reporting.
• Prepares charts, documentation, and records for MCP audits, DHCS reviews, and internal quality assurance audits.
• Coordinates chart reviews, audits, and record requests in compliance with regulations.
• Supports onboarding tasks for ECM/CS/CHW staff as needed, including PAVE enrollment, MCP credentialing requirements, and verification of CalAIM and Medi-Cal required certifications.
• Tracks staff completion of mandated trainings and certifications; provides reminders and escalates as needed.
• Conducts routine audits of staff documentation for accuracy, timeliness, and compliance with ECM core service components and CS authorization requirements.
• Assists with productivity tracking, caseload monitoring, and performance dashboards to optimize team efficiency and service delivery.
• Develops and maintains streamlined administrative systems, digital tools, and documentation workflows to enhance operational efficiency.
• Acts as a resource for EHR workflows and MCP portals, supporting accurate data entry, template use, and encounter submission.
• Participates in ongoing training sessions related to ECM/CS/CHW documentation, quality assurance, and DHCS policy updates.
• Attends scheduled meetings and provides accurate notes and follow up tracking.
• Provides logistical support for the CalAIM staff, including program coordination, scheduling, staff calendars, and day to day communications.
• Maintains policies and procedures that comply with DHCS ECM/CS/CHW guidance, MCP contract requirements, HIPAA, and organizational standards.
• Monitors regulatory changes and updates related to ECM, Community Supports, and CHW services; recommends quality improvement initiatives.
• Identifies potential risks and liabilities within program operations and collaborates with leadership to implement mitigation strategies.
• Upholds confidentiality and ensures secure handling of all client and program information.
• Attends workshops, meetings, and trainings as requested by supervisor.
• Performs other related duties as assigned.

Qualifications

REQUIRED QUALIFICATIONS:

• High School diploma or equivalent required.
• At least three years of experience in quality assurance, compliance, care coordination, or administrative roles within social services or similar setting.
• Strong proficiency in Microsoft Excel, including data analysis, formulas, and creation of graphs, charts, and reports.
• Experience using electronic health records and/or Managed Care Plan (MCP) portals.
• Ability to prepare written reports, summaries, and correspondence.
• Ability to understand and follow verbal and written instructions.
• Strong verbal and written communication skills.
• Ability to maintain a high level of confidentiality.
• Excellent organization and time management skills.
• Ability to build and maintain positive internal and external relationships.
• Ability to provide exemplary customer service to staff, partners, and constituents.
• Ability to function independently and as part of a team in a fast paced, multi task environment.
• Flexibility and ability to adapt to rapidly changing program requirements.
• Experience with Medi Cal managed care, ECM, Community Supports, or CHW programs preferred.
• Must be committed to the mission and values of Episcopal Community Services.

OTHER:

• Must secure finger image screening and annual TB screening.
• Must be able to travel to various sites, possess a driver's license and have a clean DMV record.
• Must be able to meet physical requirements of the position which may include long periods at a desk and/or computer workstation, and lifting of up to 25 lbs.

MISSION ESSENTIAL:

• Demonstrate behavior that supports the organization's mission, vision, and values.
• Promote open communication and help create an environment where doing the right thing is expected and supported, not feared.
• Adhere to all company and program best practices, policies and procedures.
• Communicate effectively and model integrity, fairness, and ethical business practices.

ECS offers industry leading healthcare benefits to support your physical and mental well-being.

ECS will consider for employment qualified applicants with arrest and conviction records as consistent with San Francisco's Fair Chance Ordinance.

ECS values a workplace where every individual is respected, supported, and given equal opportunity to thrive. We are an equal opportunity employer dedicated to creating a welcoming and inclusive environment for all.