• 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

• 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.