QA QI Analyst – DMC – ODS
Location
California
Posted
19 hours ago
Salary
$95K - $115K / year
Seniority
Senior
Job Description
QA QI Analyst – DMC – ODS
California Mental Health Services Authority
• Support the implementation of DMC-ODS requirements across access, network, utilization management, reporting, member information, and quality improvement functions • Maintain utilization management tracking tools, logs, and documentation files • Coordinate credentialing/recredentialing packets and provider directory updates • Collect, organize, and analyze quality, utilization, access, grievance, provider performance, and compliance data to identify trends, risks, and follow-up needs • Coordinate meetings, agendas, materials, notes, follow-up items, and documentation for quality management, provider monitoring
Job Requirements
- Bachelor’s degree in Public Health, Behavioral Health, Social Work, Healthcare Administration, Public Administration, Psychology, Sociology, or related field, required
- Minimum of three (3) years of experience in behavioral health, substance use disorder services, quality management, utilization management, compliance, provider monitoring, program administration, data/reporting, or a closely related field, required
- Experience with DMC-ODS, Medi-Cal behavioral health managed care, substance use disorder treatment systems, or county behavioral health plan operations, strongly preferred
- Experience working within or directly with a County Behavioral Health Plan, particularly supporting DMC-ODS quality management, reporting, utilization management, provider monitoring, or compliance functions, strongly preferred
- Strong understanding of DMC-ODS, Medi-Cal behavioral health managed care, county behavioral health systems, and provider compliance requirements
- Knowledge of quality management, utilization management, provider monitoring, grievances/appeals, network adequacy, timely access, and state reporting workflows
Benefits
- Access to various applications
- Maintain confidentiality and integrity of systems
Related Guides
Related Categories
Related Job Pages
More QA Engineer Jobs
• Support CalMHSA’s regional Drug Medi-Cal Organized Delivery System (DMC-ODS) administrative model by providing clinical leadership for quality management, utilization management, provider compliance, and care delivery oversight activities. • Conduct clinical service authorization, reauthorization, and medical necessity reviews for delegated DMC-ODS functions, including residential and withdrawal management services, as applicable. • Apply ASAM criteria, DMC-ODS requirements, Medi-Cal medical necessity standards, and parity considerations to clinical review and utilization management activities. • Provide clinical consultation on access, screening, referral, care coordination, placement, transitions between levels of care, and residential step-down planning. • Develop and review clinical policies, procedures, practice guidelines, training expectations, and clinical workflow standards for delegated DMC-ODS functions. • Provide clinical leadership for provider onboarding, implementation support, and provider-facing operations related to access, screening, documentation, care coordination, and service delivery expectations. • Oversee clinical components of provider credentialing/recredentialing standards, including review of provider qualifications, scope of services, and clinical service capacity. • Lead clinical quality improvement activities, including QI Work Plan development, PIP coordination, clinical trend review, and development of clinically informed improvement strategies. • Review utilization, access, grievance, provider performance, and quality data to identify clinical risks, gaps in care, and opportunities for improvement. • Provide training and technical assistance to counties, providers, and internal teams on DMC-ODS clinical requirements, ASAM criteria, medical necessity, documentation expectations, and care coordination standards. • Represent CalMHSA in clinical quality, utilization management, provider, county, EQRO, DHCS, and other stakeholder meetings, as assigned.
• Conduct clinical audits and quality reviews • Analyze data, performance metrics, and trends to identify opportunities for continuous improvement • Develop and deliver clinical training, documentation guides, and implementation resources • Provide technical assistance to county partners to support regulatory requirements
Role Description The Software Engineering department is looking for a Junior Quality Assurance Specialist. As a Junior QA Specialist, you bring a developing foundation in both functional and automated quality assurance practices. You work closely with your development team to help ensure product quality by: - Reviewing requirements, user stories, technical designs, and acceptance criteria. - Creating practical testing approaches that validate changes across the application stack. - Contributing through a mix of manual and automation testing, including functional, regression, exploratory, and basic automated coverage. - Valuing teamwork, asking thoughtful questions, and balancing speed with quality. Qualifications - A degree or diploma in Engineering, Computer Science, Software Development, or a related field. - 1-3 years of total experience in software quality assurance, software development, or a combination of both. - Foundational understanding of software testing principles across manual and automated testing. - Experience with black box and functional testing. - Exposure to test automation concepts and experience creating or maintaining basic automated tests. - Awareness of front-end and back-end testing concepts. - Exposure to UI testing tools such as Selenium, Cypress, or Playwright. - Exposure to API testing tools such as Postman or similar tools. - Basic understanding of databases and ability to perform simple data validation using SQL. - Experience with version control systems such as Git. - Ability to read and contribute to test scripts in languages such as JavaScript, TypeScript, Python, or Java. - Ability to create and maintain test cases in a centralized test case management tool such as AIO Tests. - Strong problem-solving skills, attention to detail, and willingness to learn. - Excellent communication and collaboration skills. Requirements - Extra considerations for candidates with ISTQB Software Tester Certification Foundation Level. - Experience with Atlassian products; Jira and Confluence is an asset. - Familiarity with CI/CD pipelines and DevOps practices. - Experience testing web, desktop, or mobile applications. - Testing software in healthcare or clinical healthcare experience. - Previous experience in high data security/privacy environments. - Product knowledge in any of QHR’s main products. - Exposure to performance or load testing tools. - Experience in design, development, or implementation of a Quality Assurance Strategy. Benefits - Base salary, variable bonus established at the corporate level, competitive benefits package. - Hiring Range: $60,000 - $70,000 annual. - Final pay for this position may depend on candidate knowledge, skills, experience, and location. - Full time, permanent. - No travel required.
Role Description As a QA Specialist, you bring a strong foundation in both functional and automated quality assurance practices. You collaborate closely with development teams to ensure product success — reviewing business requirements, technical designs, user stories, and acceptance criteria to craft effective end-to-end testing strategies. Leveraging your ability to dive into the code base, you pair a QA mindset with technical insight, understanding not only what the product should do but why the underlying code behaves as it does. You balance speed with quality, are excited to try new approaches, and thrive in a fast-paced team environment. Qualifications - A degree or diploma in Engineering, Computer Science, Software Development, or a related field - 3+ years of total experience in software quality assurance, software development, or a combination of both - ISTQB Software Tester Certification Foundation Level - Strong understanding of software testing principles (manual and automated) - Proficiency in testing both front-end and back-end components - Knowledge of UI testing frameworks (e.g., Selenium, Cypress, Playwright) - Experience with API testing tools (e.g., Postman, REST Assured) - Understanding of databases (SQL and NoSQL) and ability to validate data integrity - Experience with version control systems (e.g., Git) - Ability to write and maintain test scripts in languages like JavaScript, TypeScript, Python, or Java - Experience in testing across desktop, web and mobile applications - Strong problem-solving and debugging skills - Excellent communication and collaboration skills Requirements - Strong proficiency in automation, functional, and integration testing, complemented by hands-on experience with performance and load testing - A genuine dedication to the implementation of high-quality products - Working with your development team to create and maintain a quality product - Reviewing and analyzing requirements to design a comprehensive test framework that supports both automation and functional testing, including the creation of detailed test plans and test cases - Implementing, running, maintaining, and reporting on automation testing, including reviewing the behavior and quality of other team members' automation code - Speaking into the quality needs of the product based on knowledge and experience - Setting up testing environments to successfully execute simple to complex tests - Testing against requirements and acceptance criteria through scripted, regression, and exploratory testing to ensure the solution meets business needs - Reporting and tracking high quality bugs using Jira - Advocating for quality best practices within your development team and aligning with QA Specialists from other teams to support departmental quality improvement efforts - Working to create supporting QA documentation related to products, processes, and testing practices - Validating front-end, API, and data flows as part of a full stack quality approach - Assisting with upskilling new or existing team members to drive better knowledge within the team Benefits - Base salary, variable bonus established at the corporate level, competitive benefits package - Hiring Range: $70,000 - $80,000 annual - Final pay for this position may depend on candidate knowledge, skills, experience and location - Full time, permanent - No travel required
