Clinical Specialist, ECM

HealthRIGHT 360

San Francisco, CA

JOB DETAILS
SKILLS
Acute Care, Administrative Skills, Advanced Practice Nurse (APN), Behavioral Health, Best Practices, CPR Certification, Clinical Medicine, Clinical Monitoring, Clinical Practices/Protocols, Clinical Support, Clinical Training, Community Support, Criminal Justice, Cross-Functional, Documentation, Driver's License, Engineering Change Management, Family Social Work, Federal Laws and Regulations, First Aid, Health Department, Health Insurance, Health Plan, Healthcare, Homeless Services, Leadership, Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Practical Nurse/Licensed Vocational Nurse, MCP - Microsoft Certified Professional, Maintain Compliance, Managed Care, Medi-Cal, Medical Record System, Nonprofit, Outpatient Care, Patient Care, Pharmacy, Primary Care, Psychiatry and Mental Health, Psychology, Quality Assurance, Quality Management, Quality of Life, Registered Nurse (RN), Regulatory Requirements, Social Work, State Laws and Regulations, Time Management, Training/Teaching
LOCATION
San Francisco, CA
POSTED
13 days ago

HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

Benefits and perks:

  • HR360 offers a robust benefits package, including PTO, 15 paid holidays, commuter benefits, retirement plans, and more!
  • Employees qualify for public loan forgiveness programs
  • Training and professional development opportunities
  • Work with mission driven, compassionate colleagues and make a difference every day in the work that you do.

This is a hybrid role, requiring regular in-person work at one of our primary worksites in San Francisco (SF), Los Angeles (LA), Orange County (OC), or San Diego (SD).

Candidates must be based within reasonable commuting distance of one of these locations and able to work onsite as needed.

  • JOB SUMMARY

HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic barriers to healthcare and promote health equity for all. We offer a wide range of services, including mental health care, residential and outpatient substance use treatment, and primary health services. Additionally, we provide transitional support for individuals re-entering the community after involvement in the criminal justice system. By integrating physical and behavioral health, we empower individuals to overcome challenges by addressing social determinants of health, fostering resilience, and facilitating recovery.

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

  • 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.
  • 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.
  • Valid First Aid and CPR certification or ability to obtain within 30 days of hire.
  • Valid California Driver's License and access to registered and insured transportation preferred.

Experience

  • Minimum of 3 years clinical experience, with at least 1 year in care management, population health, or related field.
  • Experience working with clients experiencing acute withdrawal from substances.
  • Previous Clinical experience working with individuals recently released from jail or prison or experiencing homelessness.
  • Experience working with Medi-Cal, Medi-Care, and private medical insurance plans preferred.
  • Experience providing trauma-informed services preferred.
  • We will consider for employment qualified applicants with arrest and conviction records.
  • Must complete a background check and livescan.

About the Company

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HealthRIGHT 360