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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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
develops forms and presentations.
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.
Responsible for the delivery of business intelligence solutions across the enterprise. Manages deployment, maintenance, and support of data access tools and reports.
To serve as first level production support for conference rooms, desktops, phones, printing, software and other computer related operations. Analyzes, investigates, and resolves reported issues. Determines underlying sources for problems and escalates issues to next level of support if necessary.
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.
The EDI Application Administrator is responsible for the installation, configuration,
maintenance, and support of EDI software applications within the organization. This role ensures
the optimal performance, availability, and security of applications to meet business needs and
user requirements.
Under guidance from the CC Manager of Regulatory Performance, the Clinical Advisor is
responsible for drafting, editing, reviewing, auditing, tracking, monitoring and maintaining
policies and procedures for Partnership HealthPlan of California. Alongside designated
organizational leadership ensures compliance with governing rules, regulations, and/or
accreditation standards. Reviews both draft and final All Plan Letters (APLs) and/or regulatory
changes and supports leaders with the research, planning, implementation and/or operational
readiness submissions across the organization.
The Clinical Advisor may support new and ongoing training and staff support needs within the
Care Coordination department through the translation...
To design, develop, and test client server and web applications at PHC. 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.
The Training and Education Coordinator will design the training program for the Utilization
Management (UM) Department’s data platforms, medical necessity software, and department
policies and procedures in consultation with UM Supervisors and Managers
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 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 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.
The Senior Healthcare Data Analyst I contributes to the overall success of the organization by
developing analytic solutions that support activities related to health services utilization
management, care coordination, quality improvement and population health. Through analyzing
patient claims, member enrollment, and other data, the Senior Healthcare Data Analyst
Responsible for the development of all processes necessary to complete all phases of the
Enterprise Data Warehouse (EDW). This includes source identification, data collection, data
transformation, normalization, rule administration, error detection and correction, data
consolidation, data storage, data distribution, schema mapping, data enrichment, and data
governance.
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.