In collaboration with Care Coordination team members, this position provides support and guidance to HealthPlan members referred to the Care Coordination Department for Case Management services and programs. The Health Care Guide I works closely with members, families, providers, community agencies, and the interdisciplinary care team to assist in coordination of benefits in a timely and cost-effective manner, while connecting members to available internal and external resources.

In collaboration with Care Coordination team members, this position provides support and guidance to HealthPlan members referred to the Care Coordination Department for Case Management services and programs. The Health Care Guide I works closely with members, families, providers, community agencies, and the interdisciplinary care team to assist in coordination of benefits in a timely and cost-effective manner, while connecting members to available internal and external resources.

To provide coordination and implementation support of defined tasks for the assigned program(s). In addition to the Program Coordinator I duties, the Program Coordinator II has a higher level of experience, conducts business analysis to evaluate programs, tracks and reports data to a higher complexity level, coordinates daily activities, communicates program status to stakeholders, and confirms that outcomes are meeting program requirements.

The Senior IT Project Manager is responsible for the successful delivery of large-scale, complex projects often involving multiple internal and external stakeholders through all phases of the SDLC. The Senior IT Project Manager helps set and follow clear project management standards including project plans, change controls, risk management, and other project management documents on given strategic initiatives. The Senior IT Project Manager assists in developing standards, managing the enterprise IT project priority list with IT Directors, and assists in IT Steering Committee meetings if needed. This position reports to the Director of IT Strategic Initiatives 

Manages the administration of various Human Resources (HR) functions including employee relations, performance management, employee development, process improvement, and other development initiatives that support general HR administration. Works closely with HR upper management to establish policies and implement procedures to accomplish the goals and objectives of Partnership within budget and within applicable legal requirements.

This position is responsible for coordinating PR projects, developing, implementing, and monitoring inventory or other operational processes, tools, and systems required for collecting, tracking, and managing information for staff performance, regulatory reports and audits. Works closely with management and staff to ensure deadlines are met and provides routine and complex administrative support for the department.

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations.

To lead the data quality improvement efforts throughout the organization. The Senior Data Quality Analyst uses their in-depth knowledge of the data and its potential quality issues to recognize and resolve data quality issues prior to them becoming data problems. This position provides organizational and technical support for the analysis, improvement and documentation of all data quality improvement efforts. This position writes the process and procedures to recognize and resolve on-going data issues. This positions is responsible to develop and implement long-term quality strategies, identify quality gaps, implement reporting processes in order to track quality improvements, enhance current systems, define and prioritize...

To be the active project manager to deliver successful projects. Sets and follows clear project management standards including project plans, risk registers, and other project management documents. Responsible for the successful delivery of IT projects and assists in developing standards, managing the enterprise IT project priority list, and IT Steering Committee meetings. 

To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Completes and processes claims and claims worksheets. Creates appropriate documentation that reflects the actions taken and status of the claim. Generates provider communication, such as letters, as necessary. Routes and tracks claims requiring review by other staff and departments, and processes when possible. Claims Examiner II is distinguished from Claims Examiner I by a higher level of autonomy and experience, as well as an ability to process a wider range of claim types.

The Senior Data Scientist I plays a pivotal role in utilizing data to generate insights, applying advanced statistical or machine learning methodologies, solving complex business problems, and influencing decision-making across the organization. This position reports to the Data Science Manager of the Health Analytics unit.

  To support the overall financial success of PHC by providing senior level responsibilities in the preparation and analysis of Generally Accepted Accounting Principles (GAAP) financial statements, statutory financial reports, budget development and internal operational reports.  Position maintains a significant role in the maintenance of the general ledger and the month end close process.  The Senior Accountant is responsible for or assists with the maintenance and configuration of the accounting systems as well as being an advance user.  The Senior Accountant has excellent analytical skills and a thorough knowledge of accounting...

The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and assign follow up inquiries from other departments, creates and revises desktop protocols, and develops forms and presentations.

To maintain accurate provider information by entering necessary data elements into several database systems. Works closely with team members and other departments to research and resolve routine and complex issues and inquiries related to provider data. In addition to the Provider Systems Data Specialist I duties, the Provider Systems Data Specialist II has a higher level of experience, more autonomy, and more complex assignments.

Under direction from the Director of Care Coordination, manages and provides direction to the Care Coordination (CC) Department Managers and Supervisors for all product lines.

To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Creates appropriate documentation that reflects the actions taken and status of the claim. Generates provider communication, such as letters. Routes and tracks claims requiring review by other staff and departments, and processes when possible.

The successful candidate will be responsible for overseeing grievance and appeal reviews, as well as conducting cultural and linguistic reviews for our subcontractors to ensure alignment with our commitment to diversity and inclusion. This role will provide support to department on promoting health equity within our organization and in the community, ensuring fair and just access to healthcare services for all members.

To be the active project manager to deliver successful projects. Sets and follows clear project management standards including project plans, risk registers, and other project management documents. Responsible for the successful delivery of IT projects and assists in developing standards, managing the enterprise IT project priority list, and IT Steering Committee meetings. 

Provides oversight of Care Coordination programs and initiatives implemented by the Care Coordination Team designed to improve the health of PHC members and to provide excellent customer service to Members and Providers.

    To provide administrative support to the department head, leadership teams, and staff as assigned. In addition to the Administrative Assistant I duties, the Administrative Assistant II has a higher level of experience and more autonomy, is involved in project coordination, identifies necessary efficiencies, and is exposed to confidential information.