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Calaim Jobs (NOW HIRING)

Jewish Family Services of Silicon Valley - JFS SV

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CalAIM Revenue Cycle Biller

Los Gatos, CA · On-site

$60K - $75K/yr

Position Summary The CalAIM Revenue Cycle Biller is responsible for coordinating billing, data submission, and reimbursement processes for California Advancing and Innovating Medi-Cal (CalAIM ...

Stepping Up Santa Cruz

CalAIM Case Manager

Santa Cruz, CA

$23 - $29.75/hr

CalAIM Case Manager Santa Cruz, California About the Organization Stepping Up Santa Cruz is a non-profit organization dedicated to supporting individuals with complex needsincluding mental health ...

Pacific Health Group

CA · Hybrid

$21 - $24/hr

Community Health Worker (CHW) - Field-Based (CalAIM Program) Schedule : Monday - Friday | 8:30 AM - 5:00 PM Work Structure : Approximately 65% field-based / 35% remote Compensation : $21.00 - $24.00 ...

Pacific Health Group

CA · Hybrid

$21 - $24/hr

Community Health Worker (CHW) - Field-Based (CalAIM Program) Schedule : Monday - Friday | 8:30 AM - 5:00 PM Work Structure : Approximately 65% field-based / 35% remote Compensation : $21.00 - $24.00 ...

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What are the key skills and qualifications needed to thrive as a California Advancing and Innovating Medi-Cal (CalAIM) Program Manager, and why are they important?

To thrive as a CalAIM Program Manager, you need expertise in Medi-Cal policy, program implementation, and healthcare administration, often supported by a degree in public health, healthcare management, or a related field. Familiarity with state healthcare systems, data analytics tools, project management software, and regulatory compliance is typically required. Outstanding organizational, leadership, and stakeholder communication skills help drive collaboration and effective program delivery. These skills are crucial for successfully managing complex healthcare initiatives that aim to improve care coordination and outcomes for Medi-Cal beneficiaries.

What are some common challenges faced by professionals working in CalAIM implementation roles, and how can they be addressed?

Professionals working in CalAIM (California Advancing and Innovating Medi-Cal) implementation often encounter challenges such as coordinating care across multiple providers, navigating evolving state guidelines, and managing complex member needs. Success in these roles requires strong communication and collaboration skills, as well as adaptability to policy changes and new workflows. Building effective relationships with community-based organizations and regularly participating in training or knowledge-sharing sessions can help address these challenges and ensure smooth program execution.

What is CalAIM?

CalAIM stands for California Advancing and Innovating Medi-Cal. It is a multi-year initiative by the California Department of Health Care Services (DHCS) to improve and transform the Medi-Cal program. CalAIM aims to streamline services, better coordinate care for individuals with complex needs, and address social determinants of health such as housing and behavioral health. The initiative focuses on whole-person care and integrating healthcare delivery across physical, behavioral, and social services.

What is the difference between Calaim vs Claims Adjuster?

AspectCalaimClaims Adjuster
Required CredentialsCertification in insurance claims processing, relevant licensesInsurance license, certification in claims adjusting often preferred
Work EnvironmentInsurance companies, third-party claims firmsInsurance companies, independent adjusting firms
Industry UsageUsed mainly in insurance claim processing rolesCommonly used in insurance claim assessment and settlement

Both Calaim and Claims Adjuster roles involve evaluating insurance claims, but Calaim typically refers to a specialized certification or platform, whereas Claims Adjuster is a broader job title for professionals assessing and settling claims. Understanding these differences helps job seekers target the right roles and certifications in the insurance industry.

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Calaim jobs near you
Infographic showing various Calaim job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 94% Full Time, 4% Part Time, and 1% Temporary. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.

Case Manager - CalAIM Fresno

RH Community Builders

Fresno, CA • On-site

$28 - $30/hr

Full-time

Posted 15 hours ago

Job description

Position Summary
The Case Manager is responsible for providing direct services to clients referred to the CalAIM Enhanced Case Management Program. This position plays a critical role in coordinating care among multiple providers and addressing clients' medical, behavioral, and social service needs. The Case Manager creates individualized care plans that meet health plan requirements and address barriers to care, including providing health education and coaching to promote long-term self-sufficiency.
The Case Manager also serves as the primary point of contact for a client's care team, which may include primary care providers, behavioral health professionals, housing support services, SUD providers, and natural supports. If a client is dually enrolled in CalAIM Community Supports, the Case Manager may also provide Housing Navigation or Housing Tenancy services as needed.
Essential Duties and Responsibilities
The essential functions include, but are not limited to the following:
  • Serve as the Case Management Case Manager for assigned clients
  • Maintain accurate and timely documentation and client records in compliance with program requirements
  • Provide "hand-holding" services, including accompanying clients to initial appointments and helping them navigate health systems
  • Deliver psychoeducation and teach clients the importance of addressing medical needs proactively
  • Educate clients on how to attend and prepare for regular medical appointmentsProvide guidance on how untreated or unmanaged medical conditions may worsen over time
  • Act as a liaison among all of the client's providers, ensuring coordinated and integrated service delivery
  • Advocate for the client's needs while promoting client voice and choice in all aspects of care
  • Support clients in accessing essential needs, such as food, transportation, housing, and public benefits
  • Help clients develop daily living skills and long-term self-sufficiency
  • Identify and reduce barriers to care, including transportation, health literacy, or psychosocial challenges
  • Participate in multidisciplinary team meetings and collaborate with community partners

Minimum Qualifications (Knowledge, Skills, and Abilities)
  • Minimum of 2 years of experience in case management, care coordination, or a related social services role
  • Knowledge of the Fresno Madera Continuum of Care and Housing Services
  • Strong knowledge of medical terminology and chronic health conditions
  • LVN (Licensed Vocational Nurse) certification highly recommended
  • Prior experience working with individuals experiencing homelessness, serious mental illness, substance use disorder, or complex physical health conditions preferred
  • Familiarity with Medi-Cal, CalAIM, or managed care systems is a plus
  • Demonstrated ability to provide compassionate, client-centered care and health education
  • Excellent interpersonal, organizational, and written communication skills
  • Proficient in documentation and case noting in electronic systems
  • Clean driving record

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