Clinical Specialist, ECM

HealthRIGHT 360; Santa Ana (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

HealthRIGHT 360 seeks a Clinical Specialist to provide clinical oversight for ECM programs. The role coordinates behavioral health, physical health, and community services for high-need Medi-Cal members.

The position involves integrating evidence-based practices, ensuring regulatory compliance, and supporting care teams in complex cases across various settings. This is a hands-on clinical leadership role focused on improving outcomes for vulnerable populations.

Qualifications

• Must hold a clinical license or credential as applicable.
• Experience with population health or care management is preferred.
• Ability to deliver trainings and staff development sessions.

Responsibilities

• Develop and implement clinical strategies aligned with ECM program goals.
• Provide clinical oversight and guidance to ECM team and ensure effective interventions.
• Review assessments and care plans for quality and compliance.
• Maintain documentation in EHR/provider systems within 24 hours.
• Collaborate with multidisciplinary teams and community resources.
• Support trainings and provide ongoing clinical guidance to staff.
• Participate in meetings, trainings, and workshops as assigned.

Skills

Clinical leadership

Care coordination

Regulatory compliance

Education

Master’s degree in Psychology, Counseling, Social Work, Marriage and Family Therapy, or related field

Tools

EHR systems

Job description

JOB SUMMARY

CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and payment reforms across the Medi-Cal program. A key feature of CalAIM is the statewide introduction of an Enhanced Care Management (ECM) benefit and a menu of Community Supports, which, at the option of a Managed Care Plan (MCP), publicly funded health insurance plans for low-income citizens, can address the clinical and non-clinical needs of Populations of Focus with the most complex medical and social needs.

The Clinical Specialist supports HealthRIGHT 360’s ECM programs by providing clinical oversight, consultation, and guidance for complex member cases. This role ensures care is person-centered, evidence-based, and aligned with regulatory requirements while supporting care teams in coordinating behavioral health, physical health, and community-based services for high-need Medi-Cal members.

KEY RESPONSIBILITIES

Clinical Strategy

• Support development and implementation of clinical strategies aligned with program goals.


• Integrate evidence-based practices into care delivery.


• Evaluate and recommend clinical models, care pathways, and best practices.


• Partner with leadership on quality improvement initiatives.

Clinical Oversight

• Provide clinical oversight and guidance to the ECM team.


• Ensure clinical interventions are effective, appropriate, and efficient.


• Review Comprehensive Assessments, additional assessments, and Care Plans for quality and compliance.


• Ensure adherence to local, state, and federal regulations.

Clinical Support and Training

• Develop and deliver trainings on clinical topics, care coordination, and student engagement.


• Provide ongoing consultation and support to staff, including complex case debriefs.


• Offer clinical and administrative guidance as needed.


• Support escalated or high-acuity ECM member cases.


• Trainings may be delivered in-person, virtually, in field-based settings, or as otherwise assigned.

Administration and Other Duties

• Serve as a clinical liaison between ECM, providers, and community resources.


• Participate in multidisciplinary teams, committees, and ICT meetings.


• Contribute to care plan development and updates.


• Maintain timely and accurate documentation in EHR/provider systems (within 24 hours).


• Attend required meetings, trainings, and workshops.


• Complete assigned trainings in a timely manner.

And perform other duties as assigned.

QUALIFICATIONS

Credentials

• Primary care physician, specialist physician, psychiatrist, psychologist, pharmacist, registered nurse, LVN, advanced practice nurse, nutritionist, licensed behavioral health care professional, social worker, or other licensed behavioral health care professional.


• Master’s degree in Psychology, Counseling, Social Work, Marriage and Family Therapy, or related field from an accredited graduate school.


• Valid licensure from the California Board of Behavioral Sciences as an LMFT, LPCC, or LCSW.


• ValidFirst Aid and CPR certification or ability to obtain within30 daysof hire.


• Valid California Driver’s License and access to registered and insured transportation preferred.

Experience

• Minimum of3years clinical experience, with at least1year in care management, population health, or related field.

• Experience working with clients experiencing acute withdrawal from substances.

• PreviousClinical experience working with individuals recently released from jail orprison or experiencing homelessness.

• Experience working with Medi-Cal, Medi-Care, and private medical insurance plans preferred.

• Experience providing trauma-informed services preferred.