To design, develop, and test client server and web applications at PHC. To work with the Director, Web Applications Development in the design, development, testing, and deployment of web and desktop applications. Works closely with IT staff in developing applications in business needs supporting AMISYS Advance and networked systems. Assumes senior role in developing applications and supporting existing applications and other applications, as appropriate.

Responsible for the development of all processes necessary to complete SDLC phases of the Web Applications and Automation projects. This includes understanding of business processes, source identification, process design, data collection, data transformation, normalization, error detection and correction, data storage, data linage management, data achieving, and ETL Process oversight for web applications.

The Data Integration Developer is responsible for designing, developing, and maintaining data integration solutions with a focus on EDI (Electronic Data Interchange) for healthcare applications. This role involves implementing ETL processes, managing data pipelines, ensuring data quality, and generating reports to support business intelligence and compliance with

The Regulatory Affairs Specialist II has demonstrated competencies in supporting the plan-wide regulatory affairs and compliance program, including activities related to HIPAA, Fraud, Waste, and Abuse (FWA), and compliance issues. As such, conducts investigations to effectively prevent, detect, and mitigate healthcare FWA, privacy and compliance issues. Supports daily operations of the Regulatory Affairs unit by ensuring deliverables and all case management performance metrics are met for assigned cases. This position serves as an investigative liaison between the plan and our regulatory agencies and internal departments.

To respond to member and provider issues and inquiries. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.

To begin Treatment Authorization Requests (TAR) reviews and perform data entry upon TAR determination by pharmacy staff. Performs eligibility and benefit investigations. Supports pharmacy department with extracting and collecting data for reporting needs. Supports department's administrative needs, and participates in special projects as assigned by pharmacy technician lead, supervisor, and departmental staff.

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

To develop, implement, improve, and manage assigned programs. The Program Manager I is responsible for the overall success for the assigned program(s) and their role extends beyond completion of individual tasks. Programs are ongoing, which may include aligned projects and requires strategic planning and continuous improvement efforts after program startup.

The Senior Healthcare Data Analyst I contributes to the overall success of the organization by developing analytic solutions that support activities related to health services utilization management, care coordination, quality improvement and population health. Through analyzing patient claims, member enrollment, and other data, the Senior Healthcare Data Analyst

The Senior Healthcare Data Analyst I contributes to the overall success of the organization by developing analytic solutions that support activities related to health services utilization management, care coordination, quality improvement and population health. Through analyzing patient claims, member enrollment, and other data, the Senior Healthcare Data Analyst

To respond to member and provider issues and inquiries. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.

To gather and validate healthcare practitioner credentialing information in accordance with regulatory and accreditation standards. Interacts with practitioners by phone to ensure timely receipt of information. Responds to inquiries via telephone and email.

Under the direction of the Director of Quality and Performance Improvement (QI/PI), the Manager of Performance Improvement is responsible for key initiatives within the QI/PI Department: - The Partnership Improvement Academy and its associated programs; - Strategic, organization-wide improvement initiatives; - Focused...

To effectively lead assigned projects, utilizing appropriate project management methodologies to drive the planning, implementation, and tracking of projects through all aspects of the project lifecycle. Project Managers are responsible for the planning, procurement, and execution of a project.

To support in the planning, organization, management, and implementation of projects.

To design, develop, and test data transformations processes and related process automation at PHC.  To work with the Manager of Web Application Development in the design, development, testing, maintaining and migrating the databases and its related processes. Works closely with web Development team to maintain databases and its documentation. 

At Partnership HealthPlan of California, the Microsoft 365 Solutions Engineer plays a key role in supporting and optimizing the organization’s Microsoft 365 environment to enable secure, efficient, and collaborative digital operations. This position is responsible for the architecture, administration, and lifecycle management of core Microsoft 365 services, including Exchange

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. 

The Medicare Operations Analyst is responsible for ensuring operational excellence across delegated entities during implementation and post Go-Live implementation for Medicare DSNP program. In collaboration with the respective department, this role oversees implementation and post-implementation day-to-day operations including enrollment, claims processing, utilization/case management (UM/CM), and call center performance. The Analyst will monitor, audit, and collaborate with delegated partners to ensure adherence to CMS regulations, organizational policies, and contractual requirements. Review daily/weekly/monthly operational reports.

This position manages, configures, and maintains Partnership’s HR systems, such as the learning management system (LMS), performance management system, health and wellness system, external content providers, and the employee engagement system. This individual will ensure that all managed systems will meet all regulatory compliance needs and verify data accuracy and