Director of Medi-Cal Billing

About Cardea Health:

Cardea Health is a non-profit organization dedicated to providing compassionate health care to marginalized populations. Our mission is to create and support programs that protect the health and autonomy of vulnerable individuals and promote equity and social justice to improve the well-being of our entire community. We provide medical support to populations that experience homelessness. At Cardea, we are dedicated to creating a workplace that celebrates diversity and actively seeks to include underrepresented communities. We believe that diversity drives innovation and fosters a more dynamic, inclusive, and productive work environment. We actively encourage individuals from underrepresented backgrounds to apply for our open positions. We value your unique perspectives, experiences, and talents, and we are committed to providing equitable opportunities for growth and advancement. Join us in building a team that reflects the rich diversity of our society and let's make a positive impact together.

Primary Work Location:

Hybrid, supporting all our physical clinical supportive housing sites. Work from home is at the discretion of the Medical Billing Manager. On-site presence is needed periodically at various sites across the Bay Area.

Job Summary:

The Director of Medi-Cal Billing is a strategic and operational leader responsible for overseeing all aspects of Cardea Health's Medi-Cal billing, enrollment, and revenue optimization functions. This role ensures the financial sustainability of programs by maximizing reimbursement, reducing denials, and building scalable billing infrastructure to support organizational growth. Reporting to the CEO, this leader partners closely with Finance, Clinical, Compliance, and Program leadership to align billing operations with evolving Medi-Cal requirements and new program implementation. This role requires a highly driven, solutions-oriented leader who is relentlessly persistent in resolving billing challenges, navigating payer systems, and ensuring payment for services delivered.

Job Duties:

Strategic Leadership & Revenue Optimization Develop and execute a comprehensive Medi-Cal billing and revenue cycle strategy aligned with organizational growth goals Identify and implement opportunities to improve reimbursement, reduce denials, and accelerate cash flow Lead billing readiness and infrastructure development for new programs, services, and contracts Serve as internal subject matter expert on Medi-Cal billing (FFS, managed care, waivers, TARs, etc.) Team Leadership & Operations Lead, develop, and scale the Medi-Cal billing team, including billers and enrollment staff Establish performance metrics, workflows, and accountability systems to ensure high-functioning operations Foster a culture of persistence, ownership, and continuous improvement Step into operational workflows as needed to resolve complex issues or bottlenecks Billing Execution & Oversight Oversee all billing functions, including: Treatment Authorization Requests (TARs) Claims submission (Medi-Cal and managed plans) Eligibility tracking and enrollment Denials management and appeals Ensure timely, accurate submission and follow-up on all claims Drive aggressive follow-up strategies to minimize outstanding receivables Compliance, Audit & Partnerships Ensure compliance with all Medi-Cal billing regulations and documentation requirements Partner with Compliance and Finance on audits, reporting, and regulatory readiness Support contracting and billing alignment with key partners (e.g., Alameda County, managed care plans) Maintain readiness for external audits, reviews, and payer inquiries Cross-Functional Collaboration Partner with clinical and program teams to ensure documentation supports billing requirements Work with Finance to ensure accurate revenue recognition and forecasting Advise leadership on billing implications of program design and expansion

Minimum Required Skills & Qualifications:

Deep expertise in Medi-Cal billing, including managed care and fee-for-service environments 5-8+ years of progressive experience in medical billing/revenue cycle, including leadership experience Proven success optimizing billing operations and increasing reimbursement rates Strong analytical, problem-solving, and systems-thinking skills Demonstrated ability to navigate complex payer systems with persistence and urgency Experience managing teams and building scalable processes in a growing organization

Preferred Skills & Qualifications:

Experience in nonprofit, community health, or services for high-acuity populations Familiarity with California waiver programs and housing-based healthcare models Experience billing Medi-Cal waiver programs (HCBA, ALW, CalAIM including housing community supports and enhanced care management) Experience implementing billing for new programs or service lines Bachelor's degree in Healthcare Administration, Business, or related field (Master's preferred)

Physical Requirements:

Comfortable working at a desk and computer monitor for the duration of work Prolonged periods of sitting at a desk and working on a computer

Work Environment:

Hybrid. Onsite work takes place at a supportive or permanent housing facility

Benefits:

Employees in this role may be eligible for a range of benefits, including Employer-supported medical, Access to dental and vision insurance, Paid vacation and sick time, Retirement plan (401k) participation with a company match, Commuter benefits, Long Term Disability, Life Insurance Eligibility for certain benefits may vary based on hours worked per week and length of employment. Specific details are provided in the benefits guide and are subject to change Cardea Health is an Equal Opportunity Employer Cardea Health is committed to diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, genetic information, marital status, national origin, disability, citizenship or veteran status. We will consider qualified candidates with criminal histories in a manner consistent with the requirements of the state of California and San Francisco Fair Chance Ordinance. This job description is not designed to contain a comprehensive list of activities, duties, or responsibilities for this role. Activities, duties, or responsibilities may change, or a new job description may be assigned at any time with or without notice.