CHW Program Lead & Compliance Strategist

SCFHP South County Resident Advisory Group; San Jose (CA); On-site; USD 114,000 - 176,000; Full time

Job summary

SCFHP South County Resident Advisory Group seeks a Community Health Worker Program Manager to lead development and ongoing management of the Medi-Cal CHW benefit in California. You will coordinate with internal departments, vendors, and providers to ensure compliant operations, data reporting and performance measurement.

The role requires managing workflow, training, provider networks and IT alignment for CHW data needs, with strong communication and project management skills to ensure CMS/

Qualifications

• Bachelor's Degree in Healthcare, Business, social work or related field (R)
• Minimum two years of experience in health, community-based social service and/or managed care setting (R)
• Program management experience (R)
• Ability to assess training needs and develop materials (R)
• Ability to direct cross-functional projects with minimal supervision (R)
• Ability to understand, interpret and apply regulations (R)
• Advanced Microsoft Suite skills (R)
• Excellent communication skills (R)
• Facility to facilitate meetings with regulators and staff (R)
• Capacity to work under pressure and meet deadlines (R)
• Maintain confidentiality and compliance with policies (R)
• Valid California driver's license (R)
• Experience with SQL and/or Tableau (D)

Responsibilities

• Lead development and operations of the CHW benefit from project framing to outcome measurement (≤140 chars)
• Coordinate with internal departments, vendors, and consultants; validate reporting data
• Manage CHW referrals and respond to members and stakeholders in a timely manner
• Ensure workflows comply with CMS, DHCS, DMHC and NCQA regulations
• Serve as SCFHP liaison with community stakeholders and CHW network
• Develop and deliver CHW eligibility and access trainings for staff and providers
• Expand and manage contracted CHW providers and capacity
• Coordinate with IT to address CHW data needs for reporting and evaluation
• Oversee provider contracts development, approval and monitoring
• Monitor CHW data analytics and timely submission of reports
• Suggest operational improvements to management
• Maintain inventory of CHW providers and workforce capacity
• Participate in regulatory and stakeholder meetings to capture requirements

Skills

Verbal and written communication

Cross-functional project management

Regulatory understanding (CMS/DHCS/NCQ

MS Office proficiency

Problem solving

Education

Bachelor's Degree in Healthcare, Business, social work or related field

Tools

SQL

Tableau

Job description

SCFHP South County Resident Advisory Group seeks a Community Health Worker Program Manager to lead development and ongoing management of the Medi-Cal CHW benefit in California. You will coordinate with internal departments, vendors, and providers to ensure compliant operations, data reporting and performance measurement.

The role requires managing workflow, training, provider networks and IT alignment for CHW data needs, with strong communication and project management skills to ensure CMS/