Partnership HealthPlan of California

Health Care Guide II

Job Locations US-CA-Redding
Job ID
2025-3767
FLSA Status
Non-Exempt
Hiring Range
$30.38 - $36.46

Overview

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 as well as other staff within the department. The Health Care Guide II exercises a high degree of judgment, discretion, initiative, consistency and independence when working with members, families, providers, community agencies, and/or the interdisciplinary team.

Responsibilities

  • Able to independently assess referrals received and direct to other Care Coordination programs as applicable.
  • Able to navigate assigned cases within scope of practice and appropriately leverage other available resources when necessary.
  • Serves as a resource to new hires and other PHC employees regarding resource allocation and processes.
  • Responsible for training and ongoing mentorship of new care coordination staff under the guidance of HCGIIIs and Supervisors.
  • Acts as the point of contact for members, families, providers, and/or community agencies calling into the Care Coordination Department requesting assistance and information about available PHC programs and
  • Initiates and processes referrals to appropriate programs in accordance with department policies, and communicates referral outcomes to referral
  • Collaborates with members, families, providers, and/or community agencies to identify member needs and/or
  • Conducts targeted assessments to identify care coordination needs.
  • Researches appropriate and available PHC and/or community resources and provides guidance to member and interdisciplinary care
  • Creatively utilizes available resources in the most cost-effective manner in collaboration with clinical staff.
  • Assists members to ensure timely access to providers and services.
  • Initiates member centered interventions and documents identified needs and goals.
  • Completes timely and accurate documentation in appropriate systems in accordance with department policies.
  • Supports the  Care  Coordination  Department  by  answering  the  ACD  telephone  line, determining call urgency and routing calls appropriately.
  • Provides excellent customer service and communicates with others in accordance with PHC standards and expectations.
  • Responds to inquiries in a timely manner.
  • Connects members to community agencies when necessary.
  • Provides support and assistance to clinical staff as needed.
  • Exhibits high professional standards as outlined in PHC’s Code of Conduct
  • Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees.
  • Collaborates with internal PHC departments to resolve issues. 

SECONDARY DUTIES AND RESPONSIBILITIES

  • Attends at least one (1) PHC meeting involving other departments regularly.
  • Obtains records and information as requested by clinical staff.
  • Acts as a facilitator for case conferences and Interdisciplinary Care Team meetings.
  • Provides updates at department meetings as appropriate.
  • Provides periodic coverage during vacations or sick time for Health Care Guide staff as needed.
  • Attends required meetings and trainings in person when assigned.
  • Performs other duties as assigned by the direct supervisor, including the assumption of new duties. 

Qualifications

Education and Experience

 

 High school diploma or equivalent combination of experience and education required: associate’s or bachelor’s degree preferred. Minimum one (1) year of experience working within the Care Coordination department or equivalent healthcare experience recommended. Two (2) years of experience working in a health care setting recommended; or any work experience/ training or specialized education that would likely provide the ability to perform the essential functions of the position. Preference may be given to individuals certified and/or licensed in a health related field.

 

Special Skills, Licenses and Certifications

Ability to use good judgment, take personal initiative, and use discretion in performing job responsibilities. Attention to detail and accuracy. Basic knowledge of medical terminology and coding. Ability to listen actively and practice motivational interviewing. Knowledge of the PHC  and Medi-Cal benefits, and basic concepts of managed care. Ability to use computer software for word processing, spreadsheets, and email, operating multiple computer programs simultaneously. Ability to function effectively with frequent interruptions and direction from multiple team members. Ability to work in an environment with diverse individuals and groups. Ability to establish collaborative relationships. Ability to work autonomously within a team setting. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Bilingual skills in Spanish, Russian or Tagalog preferred. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and some travel for company business.

 

Performance Based Competencies

 

 

Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees. Ability to effectively employ training techniques to include teach back, active listening and motivational interviewing. Consistently exhibit high levels of critical thinking, initiative, timeliness, personal accountability, adaptability, and follow through.  Models appropriate behavior for department. Ability to work effectively with Medi-Cal and other special needs populations. Ability to work with ethnically and culturally diverse populations. Ability to maintain positive, cooperative relationships with the community, professional groups, public officials, and agencies and represent Partnership HealthPlan with professionalism, tact and diplomacy. Ability to manage multiple tasks.

 

 

Work Environment And Physical Demands

Standard cubicle workstation with a shared common area. Use of telephone, fax, computer, and photocopying machine is required. Requires sitting in front of computer equipment and talking on telephone for major portion of the workday. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Some face to face contact with members and travel potentially requiring over-night stay may be expected. When necessary, must be able to lift, move, or carry objects of varying size, weighing up to 35 lbs.

 

 

 

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

 

$30.38 - $36.46

 

IMPORTANT DISCLAIMER NOTICE

 

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform.  The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

 

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