Manages day-to-day operations of transportation services and benefits offered by Partnership HealthPlan of California (Partnership). Provides leadership, support, and education to assigned staff, and maintains relationships with providers, Partnership contracted vendor(s), community partners, and county agencies, to promote collaboration and ensure smooth and consistent application of Partnership transportation benefits. Participates in various internal venues to enhance cooperation and understanding of how the transportation program interacts with other...

The Senior Data Analytics and Reporting Developer serves as a technical leader in the design, development, and optimization of enterprise-level data reporting solutions. This role is responsible for architecting advanced dashboards, automated reporting pipelines, and analytical models that empower strategic decision-making across the organization. The Senior Developer collaborates with business leaders, drives best practices, mentors team members, and ensures data quality, scalability, and performance across reporting systems.

Manage day to day operations; provide leadership, support, and direction to the Provider Performance Oversight and Network Education and Training staff. Ensure the highest level of provider education, training, and oversight to ensure the network stays informed regarding policies and procedures, DHCS All Plan Letters and other State and Federal regulations. Monitor provider performance and identify opportunities for improvement. Monitor established goals and meet deadlines. Retain provider network through excellent customer service and education.

Supervise daily operations and provide leadership, support, and direction to assigned Provider Relations Representative staff. Ensure the highest level of customer service is a priority of PR staff. Monitor department goals and meet deadlines. Recruit and retain Provider network.

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

Responsible for assisting the HR Manager or above with the administration of Human Resources functions including HR Reporting, Personnel Actions Forms, and other human resources functions. Researches and assesses impact of proposed policies, legislation, or programs, and recommends activities or changes as appropriate. Works with staff on activities aimed at ensuring employee satisfaction and effectiveness. Interprets Human Resources policies and procedures for Partnership staff.

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

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 develop and maintain HIPAA compliant ANSI X12 transactions and support in EDI and other application development at PHC. Responsibilities include designing, coding, testing, and implementing each of the federal and/or state mandated transactions and other EDI applications using tools & technologies such as Edifecs’s Smart Trading including Spec Builder, Enterprise

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

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.

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.,...

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

To design, develop, and test data transformations processes and related process automation at Partnership.  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. 

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.

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.  Participates in the design, implementation, and/or expansion of strategic programs and departmental initiatives. Supports the development and execution of program goals, outcome measures, and program reporting.

To design, develop, and test client server and web applications at Partnership. 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.

To design, develop, and test client server and web applications at Partnership. To work with the Director of Web Applications Development in the design, development, testing, and deployment of web and desktop applications. Works closely with IT staff in developing applications for business needs supporting AMISYS Advance and networked systems. The Senior Web Applications Developer is responsible for designing, developing, testing, and supporting Web Applications.

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

The Manager of Web Applications Development is responsible for managing concurrent web and desktop development initiatives, including project level resource assignments, time estimates, and project planning details. The manager works with the Director of Web Application Development to prioritize projects, define and establish policies and procedures designed to ensure consistently high quality deliverables and high IT service performance. Lead development team through the Project and SDLC life cycles, from concept design to launch to maintenance, utilizing version control, bug tracking, and related change control processes....