Job Title: Clinical Quality SpecialistJob Description
We are seeking a dedicated Clinical Quality Specialist to ensure regulatory and accreditation compliance. The ideal candidate will maintain alignment with DHCS, NCQA, and CMS requirements through ongoing monitoring, documentation, and execution of quality-related processes. This role also involves leading quality and clinical review processes, managing the identification, documentation, and investigation of clinical grievances, quality concerns, and peer review issues in coordination with clinical leadership.
Responsibilities
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Ensure regulatory and accreditation compliance by maintaining alignment with DHCS, NCQA, and CMS requirements.
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Lead the quality and clinical review processes, managing the identification, documentation, and investigation of clinical grievances, quality concerns, and peer review issues.
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Design, implement, and evaluate programs aimed at improving clinical outcomes, enhancing care delivery, and supporting accreditation and performance standards.
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Collaborate with internal departments and external stakeholders to support organizational quality goals and ensure continuity in clinical oversight and reporting.
Essential Skills
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Minimum of three years of relevant experience or a Bachelor's or Master's degree combined with at least two years of relevant experience.
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At least two years of experience in a managed care quality management setting or a combination of academic and professional experience.
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Proficiency in developing reports and presentations tailored to diverse audiences.
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Experience working with Medicaid/Medi-Cal or Medicare managed care programs.
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Familiarity with electronic medical record (EMR) systems.
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Active, unrestricted Registered Nurse (RN) license-or a higher clinical license-authorizing practice in the state of California.
Additional Skills & Qualifications
- Case management, healthcare, medical, pediatric care management, and medical record management.
Work Environment
The work environment involves collaborating with various internal departments and external stakeholders. Proficiency with electronic medical record systems is required, and the position may involve developing reports and presentations for diverse audiences. The role requires a Registered Nurse (RN) license or higher clinical license for practice in California.
Job Type & Location
This is a Contract position based out of Santa Barbara, CA.
Pay and Benefits
The pay range for this position is $52.00 - $52.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Jun 17, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
