To provide coordination and implementation support of defined tasks for the assigned program(s).

To plan, organize, manage, and implement projects.

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 Coordinator II will coordinate assigned departmental projects and provide complex administrative support to department leaders. Develops, implements and monitors processes, tools, and systems for collecting, tracking and managing information required for monitoring performance and deadlines. Develops and produces reports. In addition to the Coordinator I duties, the Coordinator II may handle escalated calls, escalated Helpdesk inquiries, and may follow up with providers regarding missing documentation.

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

Represents PHC 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, and PHC best practices. Works independently, provides leadership on each investigation, prioritizes case deliverables, remains customer-focused, and stays current on changes in the healthcare system that may trigger member dissatisfaction.

To provide high-level support for day-to-day PC operations, production operations support, systems and telecommunications support. Supports and leads all help desk functions with PC troubleshooting, performing software updates and maintaining the inventory of PC’s and network systems hardware. Serves as the primary, secondary, and/or tertiary level escalation point for desktop, VoIP, A/V, and connectivity support to internal customers/end users. Supports IT Operations efforts in the building, implementation, testing, and deployment of new servers, software, systems, network, and security changes. Primary operations support to production environment, maintains necessary skills related to...

Design, develop, and document PHC’s core software applications and provide technical and problem resolution support to the IT department and the users.

To provide coordination and implementation support of defined tasks for the assigned program(s). In addition to the Program Coordinator I duties, the Program Coordinator II has a higher level of experience, conducts business analysis to evaluate programs, tracks and reports data to a higher complexity level, coordinates daily activities, communicates program status to stakeholders, and confirms that outcomes are meeting program requirements.

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.

This position will provide support to the Finance/Facilities department at Reception desks, in the Mailroom and with various Facilities and/or Finance related projects. This position may interact with all internal Partnership staff, visitors and guests, as well as vendors, in the course of project related tasks.

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 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 support new and ongoing training and staff support needs within the Care Coordination department, and to collaborate with other department leaders to support departmental referral volumes, caseload distributions, systems and operational workflows.

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.

In collaboration with departmental and organizational leadership, supports the organization’s Population Needs Assessment activities through active and meaningful engagement in identified community workgroup and initiatives. On behalf of the health plan identifies and supports, key strategic activities and interventions that support alignment of collective agency efforts that promote and support efforts to encourage member health outcomes.

Provides advisory and technical services to all of the HealthPlan’s contact center organizations (Member Services, Health Services, Claims, Provider Relations, and Administration) in the areas of operations, system enhancement and configuration, report generation, knowledge management, and training. Conducts business and technical requirements analysis, testing, and execution in support of the development of PHC’s contact center systems enhancements and reports. Develops and maintains an understanding of PHC’s contact center systems and reporting tools as an administrator and a user. Develops and delivers custom daily, weekly, monthly, quarterly, and yearly reporting with...

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.