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.  

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Job Locations US-CA-Fairfield
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.
Job ID
2024-2893
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To respond to member and provider issues and inquiries. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.
Job ID
2024-2891
FLSA Status
Non-Exempt
Job Locations US-CA-Redding | US-CA-Fairfield | US-CA-Eureka | US-CA-Santa Rosa
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.
Job ID
2024-2890
FLSA Status
Exempt
Job Locations US-CA-Redding | US-CA-Fairfield
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
2024-2880
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Redding
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
2024-2879
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
To assist with planning, implementing, and analyzing cultural and linguistic health education (C&LHE) services for PHC staff, Providers, and Members. Participates in state level C&LHE committee meetings and implementing work plans to meet regulatory requirements.
Job ID
2024-2877
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To gather and validate healthcare practitioner credentialing information in accordance with regulatory and accreditation standards. Provides administrative support to the Credentialing Committee. Participates in delegated oversight activities, including ensuring reports and documentation are received timely and tracked. The Credentialing Specialist II handles more complex transactions and phone calls, additional duties such as meeting minutes, agendas, or assisting with desk procedures, and answers routine questions for Specialists I’s.
Job ID
2024-2876
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Eureka | US-CA-Redding | US-CA-Santa Rosa
To Act as a Long Term Services and Supports (LTSS) Provider Liaison-Long Term Care Facilities and Skilled Nursing Facilities (SNF) and a Dental Liaison: including the responsibility of collaborating with internal departments to identify process improvement and maintaining consistent knowledge of benefit changes from the Department of Health Care Services.
Job ID
2024-2875
FLSA Status
Exempt
Job Locations US-CA-Fairfield
Under the direction of the Sr. Internal Auditor or above will conduct audits of assigned areas, assist in the internal audit initiatives as well as perform audits in accordance with the annual audit plan. As an integral member of the Internal Audit team, help the audit function keep pace with the audit needs of the organization. Applies industry standard audit procedures and documents findings in work papers in accordance with professional standards and internal audit policies and procedures. Assist in identifying weaknesses and gaps in internal controls and elevated risk areas. Participate in drafting and communication of audit recommendations and written reports. Participate in providing independent evaluations of operational and financial controls, regulatory compliance, and risk areas. Participate in performing and coordinating follow-up audits to determine if management has taken action to mitigate risks identified. Participates in special reviews as necessary.
Job ID
2024-2873
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To respond to member and provider issues and inquiries. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.
Job ID
2024-2871
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
To provide administrative support to the department head, leadership team, and staff as assigned.
Job ID
2024-2869
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
To maintain accurate provider information by entering necessary data elements into several database systems. Works closely with team members and other departments to research and resolve routine and complex issues and inquiries related to provider data. In addition to the Provider Systems Data Specialist I duties, the Provider Systems Data Specialist II has a higher level of experience, more autonomy, and more complex assignments.
Job ID
2024-2864
FLSA Status
Non-Exempt
Job Locations US-CA-Redding
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.
Job ID
2024-2863
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
To establish and maintain excellent relationships with the provider network in a specific geographic region, including healthcare practitioners, office staff, and administrators. Works closely to identify and resolve complex issues, provides education and staff training. Provides service and education via onsite visits and telephone. Assists providers with understanding Partnership HealthPlan of California's policies and procedures and assists with resolving issues that arise.
Job ID
2024-2862
FLSA Status
Exempt
Job Locations US-CA-Redding | US-CA-Fairfield | US-CA-Santa Rosa | US-CA-Eureka
Primary duty of the CSR III is to routinely process CIFs. They will be responsible to learn all CIF claim types within 18 months of accepting position.
Job ID
2024-2861
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Santa Rosa
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.
Job ID
2024-2860
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
2024-2859
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Eureka | US-CA-Redding | 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
2024-2856
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield | US-CA-Eureka | US-CA-Redding | US-CA-Santa Rosa
Provide supervisory oversight during the daily operations of the outpatient review process. Supervise and train assigned team members. Provide leadership, support, resources, and direction to staff. Assist in determining appropriateness, quality, and medical necessity of requested service.
Job ID
2024-2855
FLSA Status
Exempt
Job Locations US-CA-Fairfield | US-CA-Eureka | US-CA-Redding | US-CA-Santa Rosa
Provide a range of social work services in collaboration with PHC 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
2024-2852
FLSA Status
Non-Exempt