CalAIM Enrollment Specialist

New Beginnings Counseling Center Santa Barbara; Santa Barbara (CA); On-site; USD 41,000 - 44,000; Full time

Benefits offered by this job

Medical and dental benefits

403(b) contribution and matching

Job summary

New Beginnings Counseling Center Santa Barbara seeks a CalAIM Enrollment Specialist to support Enhanced Care Management (ECM) and Community Supports (CS). You will collaborate with the Authorization and Billing Specialists to manage enrollment, eligibility, and reporting, ensuring compliance with Medi-Cal and CalAIM requirements.

This role focuses on enrollment accuracy, eligibility maintenance, and process optimization to improve service delivery for homeless services clients served by CenCal

Qualifications

• Bachelor’s degree in social work, psychology, counseling, nursing, public health, business, or related field.
• Minimum 1–2 years of experience with Medi-Cal/CenCal systems management.
• Experience in reviewing care coordination tasks.

Responsibilities

• Enroll clients in CenCal and CalAIM; process enrollment paperwork.
• Track eligibility to prevent coverage lapses.
• Review case notes to ensure accurate documentation and reimbursement.

Skills

Medi-Cal/CalAIM knowledge

Enrollment & eligibility tracking

Documentation & reporting

Communication & collaboration

HIPAA compliance

Education

Bachelor’s degree in social work, psychology, counseling, nursing, public health, or related field

Tools

HMIS

Microsoft Office

Care management software

Job description

Full-time, hourly, non-exempt. We are seeking a CalAIM Enrollment Specialist to join our agency. The CalAIM Enrollment Specialist will be a key part of our continued efforts to provide holistic human services to our clientele.

Position Summary

New Beginnings is seeking a qualified and experienced CalAIM Enrollment Specialist to provide comprehensive support for the Enhanced Care Management (ECM) and Community Supports (CS) programs under our CalAIM initiative. The CalAIM Enrollment Specialist will provide support in conjunction with the Authorization Specialist and Billing Specialist to ensure that all ECM and CS activities are effectively managed, including utilization management, member assignment, and reporting. This role requires a deep understanding of Medi-Cal and CalAIM processes and the ability to optimize service delivery while ensuring compliance with all relevant regulations and standards.

Key Responsibilities

• Client Enrollment: Ensure all homeless services clients are enrolled in CenCal and CalAIM as eligible and appropriate. Process all enrollment paperwork.
• Eligibility Tracking: Work with homeless services staff to ensure that all clients remain eligible for assistance as appropriate, and update and track their eligibility, ensuring no lapse in coverage.
• Case Note and Service Quality Control: Review all staff case management notes for sufficient and appropriate service provision. Ensure case notes reflect accurate treatment and interventions and meet the standard for CalAIM service reimbursement.
• Expiring Authorization Tracking: Work with CalAIM and case management staff to ensure the tracking of authorizations so re-authorizations are submitted in a timely manner.
• Process Optimization: Optimize internal and external CalAIM processes, making recommendations for improvements to enhance service delivery and program efficiency. Ensure processes are streamlined for caseworkers while still aligning with CalAIM guidelines.
• Documentation and Reporting: Review case notes for all claims made and related documentation in the Health Management Information System (HMIS). Assist in tracking authorizations and reauthorizations and assist with claims reviews as necessary to ensure accurate and timely billing.
• Quality Improvement: Participate in internal and external meetings as necessary. Provide suggestions for quality improvement initiatives to enhance the effectiveness of ECM and Community Supports programs.
• Additional Duties: Perform other duties as assigned by supervisors to support the successful implementation and operation of the CalAIM initiative.

Qualifications And Requirements

• Bachelor’s degree in social work, psychology, counseling, nursing, public health, business, or a related field.
• Minimum of 1–2 years of experience working with Medi-Cal/CenCal systems management.
• Experience in reviewing care coordination tasks.
• Proven track record in implementing CalAIM or similar healthcare programs preferred.
• Familiarity with utilization management, provider oversight, and billing processes in a healthcare setting.

Skills and Competencies

• In-depth knowledge of Medi-Cal, CalAIM, the CalAIM Portal, and the needs of the Medi-Cal member population.
• Strong team player with the ability to work cohesively and collaboratively with a variety of stakeholders.
• Excellent written and verbal communication skills.
• Strong organizational, time-management, and multitasking skills with the ability to set priorities, meet deadlines, and follow through.
• High level of accuracy and attention to detail, with the ability to analyze complex data, review documentation, and track program performance.
• Ability to work unsupervised in the field for part of a shift, with a commitment to ending homelessness through employment.
• Familiarity with client intake and assessments.
• Proficiency in PC computer systems, Microsoft Office (word processing and data entry), databases, and relevant software. Experience with HMIS or other care management software preferred but not required.
• Adherence to laws regarding confidentiality and reporting requirements, maintaining current knowledge of HIPAA certification standards, and upholding professional conduct, attitude, and appearance at all times.
• Possession of a valid driver’s license and an insured, registered vehicle at the time of application, and a valid California Class C Driver’s License at the time of appointment.

Additional Information

This is a full-time, on-site position located at New Beginnings’ main office in Santa Barbara, with travel to Mid and North County offices as needed. The Enrollment Specialist will work closely with the SPP Director, the CalAIM team, ECM and Community Supports providers, the data analyst, individual program directors, and various internal departments to ensure the successful implementation of CalAIM initiatives.

Work hours are Monday through Friday, 8:00 a.m. to 5:30 p.m., although there may be occasional evening and weekend hours to attend community events or address emergent client and administrative needs.

Benefits and Salary

• Starting salary is $30.00–$32.00 per hour, DOE, with medical and dental benefits provided, a 403(b) contribution and matching program, and generous paid time off.

New Beginnings is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, or protected veteran status.