Clinical Programs Manager

Roots Community Health; Oakland (CA); Presencial; USD 110.000 - 150.000; Jornada completa

Descripción de la vacante

Roots Community Health in Oakland is seeking a Clinical Programs Manager to oversee operational execution, cross-program integration, quality performance, and sustainability of clinical initiatives. You will design and maintain systems for CHW Medi-Cal billing and service documentation to support compliant, efficient care delivery.

Reporting to the Director of Clinical Programs, Quality, and Learning, you will lead multidisciplinary teams, implement trauma-informed practices, and partner with

Formación

• Program Leadership & Project Management: Plan, organize, manage, and scale complex clinical programs and cross-functional teams.
• CHW Billing & Systems Building: Deep knowledge of CHW billing rules and EHR documentation workflows.
• HEDIS & Quality Improvement: Expertise in clinical quality metrics and population health strategies.
• Resource & Budget Management: Manage resources efficiently and ensure grant deliverable compliance.
• Cross-Program Integration: Build integrated workflows across multidisciplinary teams.
• Event & Outreach Execution: Coordinate community outreach events and field health screenings.
• Trauma-Informed Leadership: Foster a compassionate workplace prioritizing health equity and staff well-being.
• Cross-Cultural Communication: Strong written and verbal communication with diverse communities.

Responsabilidades

• Oversee development, implementation, and cross-program integration of clinical initiatives across Roots sites.
• Drive strategies that break down silos and ensure a seamless continuum of care.
• Collaborate with Clinical Directors to improve patient outcomes and address health disparities.
• Implement trauma-informed approaches to program delivery for patients and staff.
• Design, implement, and maintain SOPs and workflows for CHW Medi-Cal billing and documentation.
• Train and audit staff on CHW billable activity, coding, and EHR requirements.
• Establish KPIs for CHW productivity and documentation timelines.
• Collaborate with Finance, Billing, Compliance, and Quality to resolve billing issues and ensure compliance.

Conocimientos

Program Leadership

CHW Billing & Systems

HEDIS & Quality Improvement

Resource & Budget Management

Cross-Program Integration

Event & Outreach Execution

Trauma-Informed Leadership

Cross-Cultural Communication

Educación

Bachelor’s degree in Public Health, Healthcare Admin, Social Work, Nursing, or related field

Master’s degree (MPH, MSW, MHA, MPA)

Herramientas

EMR/EHR systems

G-Suite

Microsoft Office Suite

Data management tracking tools

Descripción del empleo

Description

Position Summary: Under the direction of the Director of Clinical Programs, Quality, and Learning, the Clinical Programs Manager oversees the operational execution, cross-program integration, quality performance, and sustainability of Roots’ clinical initiatives. This position plays a pivotal role in designing, building, and maintaining systems and accountability structures for Community Health Worker (CHW) Medi-Cal billing and service documentation.

Duties And Responsibilities

Program Management, Strategy & Integration

• Manage the development, implementation, expansion, ongoing refinement, and cross-program integration of clinical initiatives (e.g., Asthma, Respiratory Health, Harm Reduction/HIV, Complex Care/Housing) across all Roots sites.


• Drive program strategies that break down silos across clinical and community-based programs, ensuring a seamless continuum of care, unified workflows, and multi-directional referral pathways for members.


• Work closely with Clinical Directors and Medical Leadership to ensure clinical programs effectively improve patient outcomes and address emerging health disparities.


• Implement a trauma-informed and compassionate care approach to program delivery from both a patient-centered and staff wellness perspective.

CHW Billing Systems, Implementation & Accountability

• Design, implement, and maintain operational systems, standard operating procedures (SOPs), and accountability workflows to support Medi-Cal Community Health Worker (CHW) benefit billing and revenue optimization.


• Train, onboard, and audit program staff on CHW billable activity documentation, coding guidelines, care management logs, and Electronic Health Record (EHR) charting requirements.


• Establish key performance indicators (KPIs) and accountability metrics for CHW productivity, documentation timelines, and claim submission accuracy.


• Collaborate with Finance, Billing, Compliance, and Quality teams to resolve billing rejections, optimize CHW benefit utilization, and ensure compliance with DHCS, Medi-Cal managed care health plans, and state/federal rules.

HEDIS Measures & Clinical Quality Optimization

• Lead the development, integration, and monitoring of targeted clinical programs designed to improve HEDIS quality measures (e.g., asthma medication ratio, chronic disease screenings, preventive visits, diabetes care, immunizations).


• Partner with Quality and Data teams to analyze population health data, track HEDIS performance gaps, and design targeted clinical interventions and \"in-reach\" / outreach campaigns.


• Translate HEDIS targets into actionable daily workflows and care panel priorities for Coordinators, Specialists, and CHWs.

Resource Management & Outreach Event Support

• Manage, allocate, and monitor clinical program resources, staffing, materials, and specialized clinical assets to ensure optimal utilization and budget alignment.


• Assist Program Coordinators in developing, tracking, and managing program budgets, grant deliverables, and contract expenditures.


• Provide active, field-based management and logistical support for community outreach events, health fairs, and weekend/evening field initiatives.


• Cultivate and sustain collaborative partnerships with local emergency departments, health systems, housing providers, and community-based organizations to support external referrals and program visibility.

Staff Supervision & Team Leadership

• Provide direct supervision, mentoring, coaching, and performance management to assigned Program Coordinators and Specialists.


• Make and recommend personnel decisions, including recruitment, hiring, performance reviews, professional development, and performance improvement plans (PIPs).


• Plan and facilitate team meetings, inter-departmental case reviews, and continuous learning opportunities.

Compliance, Data & Reporting

• Oversee timely and accurate data collection, EHR entry, and reporting to satisfy contract guidelines, grant requirements, and internal performance metrics.


• Ensure strict adherence across all teams to HIPAA, patient privacy laws, consent protocols, and shared care guidelines.


• Support the leadership team in writing funding proposals, grant renewals, and compliance reports for clinical programs.


• Perform other related duties or clinical services within the area of licensure (if applicable) as assigned.

Requirements

Competencies:

• Program Leadership & Project Management: Proven ability to plan, organize, manage, and scale complex clinical programs, HEDIS initiatives, and cross-functional teams in a fast-paced community health environment.


• CHW Billing & Systems Building: Deep knowledge of CHW scope of practice, Medi-Cal CHW billing rules, EHR documentation workflows, and system implementation for service monetization.


• HEDIS & Quality Improvement: Expertise in clinical quality metrics (HEDIS), population health strategies, and leveraging clinical data to drive performance and patient outcomes.


• Resource & Budget Management: Strong fiscal responsibility with experience analyzing budgets, managing resources efficiently, and ensuring grant deliverable compliance.


• Cross-Program Integration: Exceptional skill in building collaborative, integrated workflows across multidisciplinary teams (medical, behavioral, CHW, housing, and social services).


• Event & Outreach Execution: Hands-on experience coordinating event logistics, community outreach, and managing field-based health screening/education events.


• Trauma-Informed Leadership: Ability to foster a compassionate, trauma-informed workplace culture that emphasizes health equity, non-judgmental advocacy, and staff well-being.


• Cross-Cultural Communication: Outstanding written and verbal communication skills, with a deep commitment to serving low-income, unsheltered, and racially diverse communities.

Qualifications & Work Experience

• Required Education: Bachelor’s degree in Public Health, Healthcare Administration, Social Work, Nursing, or related field required.


• Preferred Experience:


• Master’s degree (MPH, MSW, MHA, MPA).


• Minimum 3 to 5 years of experience managing or coordinating clinical, public health, or community health programs.


• Minimum 2 years of direct staff supervision experience in a community health center or FQHC, community clinic, or non-profit organization.


• Demonstrated experience in developing and implementing Medi-Cal/CHW billing workflows and billing compliance.


• Demonstrated background in HEDIS quality measure tracking and quality improvement interventions.


• Licensure/Certifications: Valid California Driver’s License with a clean driving record and reliable transportation required.


• Technical Skills: Proficiency in EMR/EHR systems, G-Suite, Microsoft Office Suite, and data management tracking tools.


• Flexibility: Willingness and availability to work a flexible schedule, including evenings and weekends for community outreach events as needed.