Job Listings

The Manager of Utilization Management (UM) will provide leadership and clinical oversight for operational aspects of UM, including the responsibility for providing daily oversight, leadership, support and management of assigned staff. 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 federal regulations, and to fulfill all contractual requirements.

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member’s representative in a care plan that assists the member in meeting his/ her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes.   In addition to the Care Coordination Case Manager I duties, the Care Coordination Case Manager II has a higher level of experience, evaluates special requests, assists benefit interpretation, serves as a liaison between the line staff and the supervisor,...

The Accountant II-Cash Management (Banking Operations) position will be a key member of the cash management team and is responsible for various treasury functions, including monitoring and recording of daily bank transactions, completing month end close and reconciliation activities related to bank and investment account activity and will assist in the completion and analysis of various cash and treasury related reports such as the cash flow statement, cash flow projections and investment reports. Banking activity includes managing the information flow from the banks and to the banks.   This position will be one of the main points of contact for external parties such as bankers...

The Accountant II-Cash Management (Accounts Receivable) position will be a key member of the cash management team and is responsible for various cash and invoicing functions, including the invoicing and posting of cash receipts for Leased Tenants, Wellness and Recovery Drug Medi-Cal Counties and other entities as required. This position will be the main point of contact for inquiries related to such invoices.   This position will possess excellent communication skills as they will not only respond to billing inquiries but will also manage the Cash Management Helpdesk and address inquiries on a timely basis.

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 federal regulations, and to fulfill all contractual requirements.

Under the general direction of the Associate Director of Health Analytics, this position is responsible for managing the Health Analytics Team at PHC. The goal of the Health Analytics Team is to help PHC improve the health of our members and the communities we serve by developing and producing high quality analytic reports of health care data for use internally and externally. To achieve this, the Manager of Health Analytics will manage, mentor, and train a group of highly motivated and highly qualified health analysts, working collaboratively with the Data Warehouse Team and the Financial Analysis Team. Collectively these three units (Health Analytics, Financial Analysis, and Data Warehouse) provide the analyst workforce and...

The Sr. Manager of HRP Transaction Management will oversee and manage HRP Transaction Management functions effectively. This entails leading a team, prioritizing tasks, establishing and enforcing standards, training staff, testing and implementing new code, analyzing user requirements, and aligning work with business priorities.

Under the direction of the Manager of Performance Improvement, the Improvement Advisor is uniquely positioned to drive improvement across PHC, our provider network, and the communities we serve. The Improvement Advisor will work internally and externally with provider practices and community partners to identify, plan, and facilitate quality improvement projects. Via individualized facilitation, this position will coach and train improvement teams to build team members’ quality improvement (QI) skills, develop their organizational capacity for QI work, and help them meet their specific QI goals. In addition to working directly with improvement teams, the Improvement Advisor will join PHC’s Performance...

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.

To assist in the day-to-day operations and management of the Member Services Department. Provides leadership and support and direction to Member Services staff.

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 design, install, configure, implement, and support all aspects of infrastructure environments, providing technical guidance and oversight and acts as a point of escalation and technical support. Responsible for server farms’ uptime, production maintenance, roll-out of new servers, and other critical deployments. Responsible for assisting in the support of PHC’s server applications, web servers, database servers, fax server, VOIP infrastructure, UNIX/Amisys systems environment, Pure storage array based SAN environment and other application servers, as determined by the Director of Network Operations. Assist senior team members with network, related hardware devices, and other...

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member’s representative in a care plan that assists the member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes.

To assist in developing and maintaining HIPAA compliant ANSI X12 EDI healthcare transactions for PHC. Responsibilities include programming the federal and/or state mandated transactions and other EDI applications using tools & technologies such as EDI Translators, Microsoft SSIS/SSRS package solutions, Microsoft Transaction SQL blocks and Oracle PL/SQL.

To provide administrative support to the department head, leadership team, and staff as assigned.

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member’s representative in a care plan that assists the member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes.

Under the direction of the Manager of Performance Improvement, the Improvement Advisor is uniquely positioned to drive improvement across PHC, our provider network, and the communities we serve. The Improvement Advisor will work internally and externally with provider practices and community partners to identify, plan, and facilitate quality improvement projects. Via individualized facilitation, this position will coach and train improvement teams to build team members’ quality improvement (QI) skills, develop their organizational capacity for QI work, and help them meet their specific QI goals. In addition to working directly with improvement teams, the Improvement Advisor will join PHC’s Performance...

To oversee active project management and 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.