Partnership HealthPlan of California

Job Listings


Here are our current job openings. Please click on the job title for more information, and apply from that page if you are interested.  The hiring range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.

 

To learn more about Partnership HealthPlan of California, please visit PartnershipHP.org. To go back to the Careers page, click here.

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Search Results Page 1 of 4

Job Locations US-CA-Fairfield
To provide administrative support to the department head, leadership team, and staff as assigned.
Job ID
2025-3836
FLSA Status
Non-Exempt
Job Locations US-CA-Redding | US-CA-Fairfield
To develop, implement, improve, and manage assigned programs. In addition to the Program Manager I duties, the Program Manager II has a higher level of experience, more autonomy, exercises independent judgement, and conducts business analysis and program analytics. Programs are ongoing, which may include aligned projects and requires strategic planning and continuous improvement efforts after program startup. Participates in the design, implementation, and/or expansion of strategic programs and departmental initiatives. Develops and delivers program goals, measures, and reports.
Job ID
2025-3835
FLSA Status
Exempt
Job Locations US-CA-Fairfield
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.
Job ID
2025-3833
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa | US-CA-Redding | US-CA-Eureka | US-CA-Eureka
To support the Claims Department in maintaining pended claims and claim adjustments within established guidelines. Reviews and processes complex claims, and supports claims examining.
Job ID
2025-3831
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa | US-CA-Redding
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.
Job ID
2025-3830
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa | US-CA-Redding
To design, produce, and analyze Claims Department operational data in support of department objectives and goals. To provide organizational and technical support for the analysis, design, configuration, and documentation of Partnership’s computer systems, and technical and problem resolution support to the systems user community. Utilize knowledge of numerous applications,
Job ID
2025-3829
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa | US-CA-Redding
To accurately perform concurrent, retrospective, and special audits on all level I claim types for all Partnership lines of business.
Job ID
2025-3828
FLSA Status
Non-Exempt
Job Locations US-CA-Redding
The Human Resources Coordinator performs a variety of confidential, administrative, and clerical tasks to support the HR department in various functions, including recruitment, employee relations, benefits, training, and compliance. Prepares correspondence, reports, and other documentation, and responds to employee inquiries.
Job ID
2025-3826
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
To oversee the appropriateness and quality of care delivered through Partnership HealthPlan of California and for the cost-effective utilization of services.
Job ID
2025-3825
FLSA Status
Exempt
Job Locations US-CA-Redding
To provide high-level support for day-to-day PC operations, production operations support, systems and telecommunications support. Support and lead all help desk functions with PC troubleshooting, performing software updates and maintaining the inventory of PC’s and network systems hardware. Serve as the primary and second level escalation point for desktop, VoIP, A/V, and connectivity support to internal customers/ end-users. Supports IT Operations efforts in the building with implementation, testing, and deployment of new servers, and software, systems, network, and security changes. Primary operations support to production environment, maintains necessary skills related to production support,...
Job ID
2025-3824
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
Manage daily operations of Provider Relations Systems and Data functions. Responsible for ensuring provider data is accurate and updated in several systems and databases. Provide leadership, support, and direction to the PR Systems and Data staff. Ensure the highest level of accuracy and timeliness of provider database configuration and maintenance.
Job ID
2025-3823
FLSA Status
Exempt
Job Locations US-CA-Fairfield | US-CA-Redding | US-CA-Chico | US-CA-Auburn
The incumbent utilizes clinical judgement in providing utilization management services. The focus is to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. Assists in determining appropriateness, quality and medical necessity of treatment plans using pre-established guidelines. This position may be assigned cases in long-term care and ancillary, DME or medical services.
Job ID
2025-3821
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
Provide a range of social work services in collaboration with Partnership staff to meet the psycho-social and care coordination needs of members. Responsible for the assessment and care coordination of the psycho-social needs of members, families and/or caregivers to help promote positive coping skills, reduce the risk of premature institutionalization, assist individuals in maintaining independence in the community and increase stabilization of social determinants.
Job ID
2025-3820
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Redding | US-CA-Santa Rosa | US-CA-Eureka
The incumbent utilizes clinical judgement in providing utilization management services.  The focus is to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary.  Assists in determining appropriateness, quality and medical necessity of treatment plans using pre-established guidelines.  This position may be assigned cases in long-term care and ancillary, DME or medical services.
Job ID
2025-3819
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Redding
The Enrollment Specialist I will assist in maintaining Medi-Cal membership and process basic functions of the Enrollment Unit. This position will review, research, and resolve Medi-Cal eligibility issues and systems related errors as well as primary care physician (PCP) assignment failures within established production and quality standards. Completes and processes reports and appropriately documents member records of actions taken to correct or update member records, PCP assignments etc. Processes reports to ensure primary care assignment is appropriate, processes certain authorized representative forms and document members records appropriately. Reports eligibility discrepancies and...
Job ID
2025-3818
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa
The Manager of Care Coordination (CC) will lead and support the department leadership in the development, implementation and evaluation of Partnership’s clinical case management services. Collaborates with Supervisor(s) to oversee the department activities and provides guidance to manage these functions to enhance cost effectiveness, ensure compliance with applicable state and
Job ID
2025-3816
FLSA Status
Exempt
Job Locations US-CA-Redding
To serve as first level production support for conference rooms, desktops, phones, printing, software and other computer related operations.  Analyzes, investigates, and resolves reported issues. Determines underlying sources for problems and escalates issues to next level of support if necessary.
Job ID
2025-3815
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa
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.
Job ID
2025-3814
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Redding
The Configuration Analyst provides both operational support to, and analysis of, lower complexity Configuration-related activities. The Configuration Analyst creates, updates, tests and maintains system configuration to support all benefit designs and ensure successful configuration, integration, and accurate and timely payment of claims and all Partnership systems. Coordinates testing, quality assurance, configuration, installation, and support to ensure smooth, stable and timely implementation of technology solutions, considering all the areas that a change may impact in the current benefit setup and determine the most appropriate way to implement the change (e.g.,...
Job ID
2025-3813
FLSA Status
Exempt
Job Locations US-CA-Fairfield | US-CA-Redding | US-CA-Eureka | US-CA-Chico
Represents Partnership in the Grievance & Appeals Resolution process. Responsible for reviewing, investigating, and resolving assigned member grievance and appeal cases ranging from low to high complexity. Works to transform member dissatisfaction into member satisfaction. Oversees the investigative process ensuring casework complies with DHCS guidelines, NCQA standards,
Job ID
2025-3812
FLSA Status
Exempt