Director, Clinical Quality Assurance

Role: Director, Clinical Quality Assurance

Reports to: Chief Compliance Officer

Program: 9007-Quality Assurance & Comp

Department: Compliance

Location: Wellness Center - 345 S. San Pedro Street, Los Angeles, CA 90013

Setting: Not 100% Onsite

Schedule: Monday - Friday, 8:00am - 4:30pm

Status: Full-time/Exempt/Management

Benefits: Medical, Vision, Dental, Life Insurance, 403(b) Retirement plan, Employee Assistance Program (EAP), etc.

Openings: 1

Job Description Summary:

The People Concern is funded through the Los Angeles County Department of Mental Health (LAC DMH) and LA Care to deliver Mental Health and Enhanced Care Management (ECM) services. These programs provide mental health treatment, case management, and care coordination to individuals experiencing homelessness, transitioning into permanent supportive housing, or residing in permanent housing.

Reporting to the Chief Compliance Officer, the Director of Clinical Quality Assurance provides strategic leadership for the agency's clinical compliance, quality assurance, and billing integrity efforts. Through direct oversight of the Clinical Quality Assurance team, the Director ensures consistent adherence to organizational, regulatory, and funder standards; leads continuous quality improvement initiatives; and supports clinical and program staff in meeting LAC DMH, LA Care, CalAIM, and other applicable regulatory requirements.

Job Description Essential Duties and Responsibilities:

Reporting to the Chief Compliance Officer, the Director of Clinical Quality Assurance is responsible for the following:

• Ensure organizational compliance with CalAIM requirements and all applicable Los Angeles County Department of Mental Health (LAC DMH) and LA Care's Enhance Care Management (ECM) policies, procedures, and contractual standards.
• In collaboration with the Chief Program Officer and Deputy Chief over Mental Health Programs, monitor LA DMH and LA Care contracts, including funding streams, budget utilization, and allowable expenditures to ensure fiscal and contractual compliance.
• Partner with the Chief Program Officer over Mental Health Programs and Finance Department to develop Negotiation Packages, fiscal reports, and other documentation required by LAC DMH and LA Care.
• Develop and deliver training for clinical and non-clinical staff on LAC DMH and ECM documentation standards, quality assurance expectations, and regulatory requirements.
• Work closely with the Chief Program Officer and Deputy Chief over Mental Health and Health and Wellness Programs and Program Directors and Managers to ensure adherence to agency policies and procedures and the delivery of high-quality, compliant clinical care.
• Serve as the administrator for the agency's Electronic Health Record (EHR) system, Exym, including oversight of system configuration, workflows, access contracts, and data integrity.
• Oversee all client record requests and releases of information, ensuring compliance with HIPAA, state confidentiality laws, and contractual requirements.
• Direct the collection, analysis, and reporting of clinical outcome data; oversee charting standards, documentation practices, and routine chart reviews to support quality improvement and audit readiness.
• Prepare for, coordinate, and represent the agency during federal, state, county, and city audits, reviews, and sites visits related to clinical services, documentation, and quality assurance.
• Actively participate in and support quality assurance and quality improvement activities related to agency grants and contracts that fund clinical services.
• In collaboration with the Chief Compliance Officer, provide agency-wide oversight of HIPAA compliance, including privacy practices, training, and corrective action planning.
• Provide direct supervision and leadership to the Clinical Quality Assurance Team, which includes Clinical Quality Assurance Leaders and Quality Assurance Specialists.
• Design, implement, and evaluate agency-wide Quality Improvement (QI) initiatives to enhance clinical outcomes, documentation quality, regulatory compliance and overall service delivery.

Job Description Qualifications:

• Active California clinical license in good standing or a minimum of seven (7) years of direct relevant clinical quality assurance and program oversight experience required.
• Master's or doctoral degree in clinical discipline (Ph.D, Psy.D, MSW, MFT, or equivalent) from an accredited institution, preferred.
• Demonstrated expertise in clinical quality assurance, documentation standards, chart review processes, and evidence-informed clinical practices.
• Minimum of three (3) years of experience supervising and managing professional staff.
• Proven ability to work collaboratively within interdisciplinary and cross-functional teams.
• Advanced knowledge of Los Angeles County Department of Mental Health (LAC DMH) standards, documentation requirements, and information systems.
• Strong verbal and written communication skills, including the ability to prepare clear reports, training materials, and audit responses.
• High level of proficiency in data management, analysis, and reporting to support quality improvement and compliance activities.
• Clinical knowledge and experience in evidence-based practices, including cognitive behavioral therapy, solution-focused interventions, trauma-informed care, substance use treatment, and related modalities.
• Demonstrated knowledge and experience with HIPAA, the Affordable Care Act, and CalAIM Enhanced Care Management.
• Able to work on-site in programs utilizing a high-tolerance, harm reduction service model and to engage effectively with clients experiencing multiple and complex barriers to care.

Job Description Work Environment:

• Primarily indoor office environment
• Walk or drive to different local sites at least 25% of the time
• Regularly required to sit, stand, bend and occasionally lift or carry up to 35 pounds
• May necessitate working in busy and loud environments
• May be exposed to elements like cold, heat, dust, noise, and odor
• May need to bend, stoop, twist, and sit throughout the day