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AIM PROGRAM SPECIALIST

Meals on Wheels Diablo Region - 4.1 Walnut Creek, CA Job Details Full-time $28.98 an hour 1 day ago Benefits Health insurance Dental insurance Flexible spending account Paid time off Vision insurance 401(k) matching Qualifications Spanish Software development experience within healthcare industry Spreadsheets English Driver's License Attention to detail Older adults Organizational skills Full Job Description

PROGRAM DESCRIPTION

The Health and Wellness Division supports Contra Costa County residents aged 60 and older by offering companionship, education, and access to key services. Programs include friendly visits or phone check-in calls, exercise classes, nutrition education, and CalAIM Community Health Worker (CHW) services. Its mission is to enrich the well-being of older adults by fostering connection, providing essential resources, and encouraging active, healthy living.

SCOPE OF WORK

The CalAIM Program Specialist is responsible for coordinating and tracking the day-to-day administrative and operational workflows that support the successful delivery, documentation of Friendly Programs, and claims processing of CalAIM Community Health Worker (CHW) services. This position serves as a key point of coordination between the Friendly Services and CalAIM teams. The specialist ensures that referrals, eligibility verification, authorizations, claims, reporting, and client transitions and discharges are completed accurately, promptly, and in compliance with program requirements. In addition to completing assigned tasks, the specialist is responsible for maintaining accurate data entry, preparing monthly GetCare reports, actively monitoring workflows, following up on outstanding issues, documenting actions taken, and ensuring all items are resolved and closed. Success in this role requires strong organization, attention to detail, and consistent follow-through to ensure that no critical task falls through the cracks. This position is a 40-hour-per-week position and reports to the Health & Wellness Senior Manager.

DUTIES AND RESPONSIBILITIES

Manage MCP (Managed Care Plans) referrals, track status, and follow up on missing information to ensure timely service initiation. Verify eligibility and maintain accurate service documentation to support compliance and billing requirements. Coordinate billing activities, reconcile claims and payments, and address denials, discrepancies, and related issues. Prepare, review, and submit MCPreports and compliance documentation, ensuring data accuracy and timeliness. Track clinical approvals, client transitions, and discharges to ensure complete and compliant documentation. Identify and resolve data, authorization, claims, and reporting issues that impact program operations. Maintain tracking systems and work queues, ensuring timely follow-up, documentation, and closure of all assigned tasks. Evaluate clients' needs and make referrals using agency programs and community resources as needed. Participate in first client visits for the Friendly Visitors program in Walnut Creek and Concord areas. Manage Special Project as needed

QUALIFICATIONS

2+ years of experience in healthcare administration, care coordination, managed care, billing, or healthcare operations. Experience with CalAIM, CHW, Medi-Cal, MCPs, claims, eligibility, or healthcare reporting preferred. Strong organizational, analytical, problem-solving, and communication skills. Ability to manage multiple deadlines and priorities with a high level of accuracy. Ability to work independently and collaborate effectively with internal and external stakeholders. Knowledge of healthcare privacy and regulatory requirements. Ability to collaborate effectively across departments and with external partners while managing multiple priorities. Proficient with spreadsheets, CaseWorthy, GetCare, and Microsoft Office applications, including Excel and Word. Demonstrated cultural competency and ability to work effectively with diverse populations, including older adults. Bilingual in English and Spanish preferred. Valid California driver's license, proof of insurance, reliable transportation, and smartphone required. Must pass a background check. Ability to lift up to 15 pounds. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time. Meals on Wheels Diablo Region provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Pay:

$28.98 per hour Expected hours: 40.0 per week

Benefits:

401(k) matching Dental insurance Flexible spending account Health insurance Paid time off Vision insurance

Experience:

CalAIM:

1 year (Preferred)

Software Proficiency:

3 years (Preferred)

Healthcare:

2 years (Required)

Work Location:

In person