Clinical Programs Manager

Description

Position Summary:

Under the direction of the Director of Clinical Programs, Quality, and Learning, the Clinical Programs Manager oversees the operational execution, cross-program integration, quality performance, and sustainability of Roots’ clinical initiatives. This position plays a pivotal role in designing, building, and maintaining systems and accountability structures for Community Health Worker (CHW) Medi-Cal billing and service documentation.

The Clinical Programs Manager drives the development and implementation of clinical programs aligned with Healthcare Effectiveness Data and Information Set (HEDIS) measures, manages and optimizes program resources, provides hands-on support for community outreach events, and fosters cross-departmental integration to deliver cohesive, trauma-informed care across all Roots sites.

Duties and Responsibilities:

Program Management, Strategy & Integration

? Manage the development, implementation, expansion, ongoing refinement, and cross-program integration of clinical initiatives (e.g., Asthma, Respiratory Health, Harm Reduction/HIV, Complex Care/Housing) across all Roots sites.

? Drive program strategies that break down silos across clinical and community-based programs, ensuring a seamless continuum of care, unified workflows, and multi-directional referral pathways for members.

? Work closely with Clinical Directors and Medical Leadership to ensure clinical programs effectively improve patient outcomes and address emerging health disparities.

? Implement a trauma-informed and compassionate care approach to program delivery from both a patient-centered and staff wellness perspective.

CHW Billing Systems, Implementation & Accountability

? Design, implement, and maintain operational systems, standard operating procedures (SOPs), and accountability workflows to support Medi-Cal Community Health Worker (CHW) benefit billing and revenue optimization.

? Train, onboard, and audit program staff on CHW billable activity documentation, coding guidelines, care management logs, and Electronic Health Record (EHR) charting requirements.

? Establish key performance indicators (KPIs) and accountability metrics for CHW productivity, documentation timelines, and claim submission accuracy.

? Collaborate with Finance, Billing, Compliance, and Quality teams to resolve billing rejections, optimize CHW benefit utilization, and ensure compliance with DHCS, Medi-Cal managed care health plans, and state/federal rules.

HEDIS Measures & Clinical Quality Optimization

? Lead the development, integration, and monitoring of targeted clinical programs designed to improve HEDIS quality measures (e.g., asthma medication ratio, chronic disease screenings, preventive visits, diabetes care, immunizations).

? Partner with Quality and Data teams to analyze population health data, track HEDIS performance gaps, and design targeted clinical interventions and "in-reach" / outreach campaigns.

? Translate HEDIS targets into actionable daily workflows and care panel priorities for Coordinators, Specialists, and CHWs.

Resource Management & Outreach Event Support

? Manage, allocate, and monitor clinical program resources, staffing, materials, and specialized clinical assets to ensure optimal utilization and budget alignment.

? Assist Program Coordinators in developing, tracking, and managing program budgets, grant deliverables, and contract expenditures.

? Provide active, field-based management and logistical support for community outreach events, health fairs, and weekend/evening field initiatives.

? Cultivate and sustain collaborative partnerships with local emergency departments, health systems, housing providers, and community-based organizations to support external referrals and program visibility.

Staff Supervision & Team Leadership

? Provide direct supervision, mentoring, coaching, and performance management to assigned Program Coordinators and Specialists.

? Make and recommend personnel decisions, including recruitment, hiring, performance reviews, professional development, and performance improvement plans (PIPs).

? Plan and facilitate team meetings, inter-departmental case reviews, and continuous learning opportunities.

Compliance, Data & Reporting

? Oversee timely and accurate data collection, EHR entry, and reporting to satisfy contract guidelines, grant requirements, and internal performance metrics.

? Ensure strict adherence across all teams to HIPAA, patient privacy laws, consent protocols, and shared care guidelines.

? Support the leadership team in writing funding proposals, grant renewals, and compliance reports for clinical programs.

? Perform other related duties or clinical services within the area of licensure (if applicable) as assigned.

Requirements

Competencies:

? Program Leadership & Project Management: Proven ability to plan, organize, manage, and scale complex clinical programs, HEDIS initiatives, and cross-functional teams in a fast-paced community health environment.

? CHW Billing & Systems Building: Deep knowledge of CHW scope of practice, Medi-Cal CHW billing rules, EHR documentation workflows, and system implementation for service monetization.

? HEDIS & Quality Improvement: Expertise in clinical quality metrics (HEDIS), population health strategies, and leveraging clinical data to drive performance and patient outcomes.

? Resource & Budget Management: Strong fiscal responsibility with experience analyzing budgets, managing resources efficiently, and ensuring grant deliverable compliance.

? Cross-Program Integration: Exceptional skill in building collaborative, integrated workflows across multidisciplinary teams (medical, behavioral, CHW, housing, and social services).

? Event & Outreach Execution: Hands-on experience coordinating event logistics, community outreach, and managing field-based health screening/education events.

? Trauma-Informed Leadership: Ability to foster a compassionate, trauma-informed workplace culture that emphasizes health equity, non-judgmental advocacy, and staff well-being.

? Cross-Cultural Communication: Outstanding written and verbal communication skills, with a deep commitment to serving low-income, unsheltered, and racially diverse communities.

Qualifications & Work Experience

? Required Education: Bachelor’s degree in Public Health, Healthcare Administration, Social Work, Nursing, or related field required. 

? Preferred Experience:

? Master’s degree (MPH, MSW, MHA, MPA). 

? Minimum 3 to 5 years of experience managing or coordinating clinical, public health, or community health programs.

? Minimum 2 years of direct staff supervision experience in a community health center or FQHC, community clinic, or non-profit organization.

? Demonstrated experience in developing and implementing Medi-Cal/CHW billing workflows and billing compliance.

? Demonstrated background in HEDIS quality measure tracking and quality improvement interventions.

? Licensure/Certifications: Valid California Driver’s License with a clean driving record and reliable transportation required. 

? Technical Skills: Proficiency in EMR/EHR systems, G-Suite, Microsoft Office Suite, and data management tracking tools.

? Flexibility: Willingness and availability to work a flexible schedule, including evenings and weekends for community outreach events as needed.