The successful candidate will be responsible for overseeing grievance and appeal reviews, as well as conducting cultural and linguistic reviews for our subcontractors to ensure alignment with our commitment to diversity and inclusion. This role will provide support to department on promoting health equity within our organization and in the community, ensuring fair and just access to healthcare services for all members.

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. 

Provides oversight of Care Coordination programs and initiatives implemented by the Care Coordination Team designed to improve the health of PHC members and to provide excellent customer service to Members and Providers.

To plan, organize, manage, and implement projects.

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

Under direction of the Associate Director of Clinical Integration, leads and supports the clinical integration team in the enhancement and refinement of existing programs and the development, management, integration and refinement of new and existing programs. The Manager of Clinical Integration will ensure successful implementation of Care Coordination programs including working closely with Care Coordination’s operational leaders and internal and external stakeholders to establish expected outcomes, plan roadmaps, and oversee alignment and execution of deliverables. The Manager of Clinical Integration will directly oversee and support the clinical integration team consisting of supervisors and individual contributors...

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. In addition to the Project Manager I duties, the Project Manager II has a higher level of experience, is more autonomous, exercises independent judgment, and as needed, conducts business process analyses across the organization to identify and implement necessary changes or improvements.

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 establish and maintain excellent relationships with the transportation provider network. Identifies service gaps and recruits new transportation providers to increase network adequacy. Works closely to identify and resolve complex issues, provides education and staff training to transportation providers and healthcare providers with members experiencing transportation access issues. Assists providers with understanding Partnership HealthPlan of California's transportation-related policies and procedures and assists with resolving issues that arise.

To lead and participate in the development of complex software systems and programs at Partnership. Collaborates with the IT Director in the analysis, design, programming utilizing specifications and applying programming standards, troubleshooting, problem resolution, maintenance, and documentation of software systems and programs. Oversees all aspects of designated application and program support including development, code installation, incident management, problem management, proactive maintenance, problem resolution.

To plan, organize, manage, and implement projects.

To plan, organize, manage, and implement projects.

To support and/or lead in planning, organization, management, and implementation of projects. In addition to the Project Coordinator I duties, a Project Coordinator II has a higher level of experience, works well with ambiguity and is expected to work with more autonomy on assignments 

To develop provider and member educational opportunities for internal departments, external agencies, training, and materials to support PHC providers, community partners, and members. Provides hands-on support to internal team as well as to PHC providers, community partners, and members.

To provide Basic Population Health Management services for members which includes engaging with members individually or as part of a group to support lifestyle modifications to manage chronic diseases, to identify care gaps and needed services, and to aid Partnership members in maintaining wellness. Healthy Living Coaches shall also serve as a resource about Partnership member benefits as well as Population Health programs and services.

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 develop provider and member educational opportunities for internal departments, external agencies, training, and materials to support PHC providers, community partners, and members. Provides hands-on support to internal team as well as to PHC providers, community partners, and members.

This position designs, develops, presents, and/or facilitates innovative and engaging organization-wide Instructor-Led Trainings (ILT), video trainings, and other trainings as requested. Works with department Subject Matter Experts (SMEs) on designing and/or standardizing targeted trainings (i.e. – department specific or audience specific trainings) as requested.

To provide administrative support to the executive leader, leadership teams, and staff as assigned. In addition to the Administrative Assistant II duties, the Executive Assistant has a higher level of education and experience and more autonomy, works with a higher level of internal/external customers, serves as liaison to external customers, and a exposed to higher confidentiality.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives.