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Specialty Mental Health Services- QA Manager (Medi-Cal Billing)

Mary's Path
Santa Ana, CA Full Time
POSTED ON 2/16/2025
AVAILABLE BEFORE 5/10/2025

Position Summary

Mary's Path is seeking a Quality Assurance Manager for our behavioral health program serving teen mothers in foster care and their babies. The QA Manager is responsible for overseeing all aspects of quality assurance across the programs, including maintaining compliance with Medi-Cal regulations, DHCS' Short Term Residential Therapeutic (STRTP) standards, CalAIM documentation requirements, contract oversight, and overall mental health audit compliance. This position is also responsible for the Medi-Cal billing, claiming, and reconciliation of all services provided by the program staff. The ideal candidate will have experience working in the non-profit / behavioral health sector, is familiar with CalAIM standards, has a keen eye for detail and follow through and is proactive.

To be considered for the Manager role, the applicant MUST have experience billing Medi-Cal specialty mental health services through a county billing system (preferably Los Angeles County system IBHIS and / or Orange County's system IRIS, but other county mental health billing systems will be considered based on the candidate's experience). The Quality Assurance Manager reports to the Head of Service.

Responsibilities

  • Organization and Role Responsibilities
  • Responsible for overseeing all billing system entries for assigned programs in coordination with program QA staff
  • Monitor Medi-Cal documentation of program staff
  • Distribute necessary information to various departments within the agency as well as outside agencies
  • Collaborate with accounting department regarding billing and invoicing systems
  • Liaison with various county personnel to ensure ongoing collaboration, field concerns, and rectify any issues
  • Liaison with Program Directors to ensure that both the needs of the program and the needs of QA are being met in a timely manner
  • Develop policies and procedures as appropriate for the role
  • Oversee Internal Audits of each program to assess for Medi-Cal, contract and agency compliance
  • Participate in the development of trainings focusing on documentation and compliance
  • Oversee QA development within new programs created within the agency
  • Ensure programmatic understanding of contracts and serve as the primary point person for all contract compliance issues
  • Additional duties as requested by the Clinical Director / Head of Service

Qualifications and Experience

  • Bachelor’s Degree, preferably in Social Services
  • Master’s Level Degree preferred, ideally in Social Services
  • Experience managing Medi-Cal billing processes within LA County’s Department of Mental Health and Orange County Health Care Agency
  • One year of supervisory experience
  • Excellent organizational, analytical, computer and communication skills
  • Strong collaboration, conflict management and trust building skills
  • High level of organizational and analytical skills
  • Understanding of, or ability to quickly learn Medi-Cal regulations and principles
  • Strong ability to prioritize work and projects
  • Demonstrated experience in developing new procedures as necessitated to improve the overall quality of the programs
  • Deep understanding of and ability to work through complex situations, with strong problem-solving skills
  • High level of self-management and accountability
  • Strong knowledge of therapeutic modalities and evidence-based practices
  • Ability to work effectively with diverse populations and communities
  • Demonstrated ability to manage multiple tasks and priorities, with the agility to flex across competing priorities while maintaining clear direction and support to staff
  • Demonstrated strength in exhibiting the following competencies : collaboration, empathy, resilience, situational adaptability and valuing the differences across diverse populations
  • Understanding and modeling of trauma-informed care, and ability to develop staff’s understanding and use of this lens
  • Physical Requirements and Environmental Conditions

    The conditions and requirements below are representative of those required for an employee to successfully meet the essential requirements of the role. Reasonable accommodation may be made to enable employees to meet these requirements.

    Must be able to remain in a stationary position, at a desk or similar, the majority of working time. Time spent in a stationary location includes operating a computer and relevant peripherals and communicating via phone.

    Mary’s Path is a non-smoking environment.

    Offered Benefits

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Paid Time Off
  • Retirement plan with employer matching
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