Los Angeles, California, United States
Ensure the quality and regulatory compliance of all Customer Solution Center (CSC) operations. Monitor call center performance across multiple departments and vendors, conduct audits and surveys to assess member experience, and identify trends or issues requiring corrective action. Collaborate with management to develop performance reports, quality tools, and process improvements, while serving as a Subject Matter Expert (SME) for all product lines (Medi-Cal, CMC, PASC, and Covered California). Responsibilities include performing data analysis, providing 1:1 coaching, participating in calibrations, supporting training and onboarding, and assisting in special quality initiatives to drive staff development and operational excellence.
Supported the Quality Improvement (QI) Manager in ensuring program and staff compliance with regulatory and contractual standards. Conducted audits, monitored data accuracy, tracked certification and licensing requirements, and assisted with Medi-Cal and DHCS processes. Responsibilities include maintaining practitioner databases, preparing performance and compliance reports, resolving billing and claims issues, and supporting staff training on QA procedures and updates.
Provided comprehensive case management and support services to individuals experiencing persistent mental illness and/or substance use challenges. Worked within an integrated healthcare setting, helped clients access medical, mental health, housing, and community resources to promote recovery and independence. Responsibilities included assessing client needs, coordinating care, providing counseling and crisis intervention, and ensuring accurate documentation in compliance with agency and regulatory standards.
Provided intensive, individualized support to children and families through behavioral interventions, skill-building, and advocacy. Worked as part of a multidisciplinary team and collaborated with the Wraparound Facilitator and Child and Family Team to develop and implement care plans that promote safety, stability, and permanency. Responsibilities included offering in-home support, linking families to community resources, and advocating across systems such as schools and social services.
Supported children ages 5–12 by creating a safe, engaging, and positive environment that promotes learning and development. Planned and led activities in areas such as homework support, arts and crafts, STEM/STEAM, physical education, and social-emotional learning. Key responsibilities included supervising participants to ensure safety, fostering positive behavior, maintaining accurate attendance records, and collaborating with parents, school staff, and community partners.