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Job Locations US-CA-Fairfield
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 Sybase Ec Map, Ec Gateway, Active Batch, SQL Server and Oracle.
Job ID
2021-1936
FLSA Status
Exempt
Job Locations US-CA-Fairfield
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 Sybase Ec Map, Ec Gateway, Active Batch, SQL Server and Oracle.
Job ID
2021-1935
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To provide high-level support for day-to-day PC operations, production operations support, systems and telecommunications support. Support and lead all help desk functions with PC troubleshooting, performing software updates and maintaining the inventory of PC’s and network systems hardware. Serve as the primary and second level escalation point for desktop, VoIP, A/V, and connectivity support to internal customers/ end-users. Supports IT Operations efforts in the building with implementation, testing, and deployment of new servers, and software, systems, network, and security changes. Primary operations support to production environment, maintains necessary skills related to production support, and functions as on call support as required. Learns advanced operations procedures and troubleshooting techniques from Director of Network Operations and documents them.
Job ID
2021-1934
FLSA Status
Non-Exempt
Job Locations US-CA-Fairfield
Design, develop, and document PHC’s core software applications and provide technical and problem resolution support to the IT department and the users.
Job ID
2021-1926
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To direct, coordinate, and manage pharmacy operations including personnel and operational responsibilities. Works to effectively lead the overall regional Pharmacy Department to drive performance, improvement, and operation efficiency. Provides daily oversight, supervision, and management of the Pharmacy Operations and Pharmacy Technicians.
Job ID
2021-1922
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To support the financial reporting and analytical processes by analyzing complex healthcare cost drivers. Develops, coordinates, and is directly involved in projects and activities that help drive business decisions, affect provider reimbursement programs.  Plays a key role in the preparation, analysis, and review of the Rate Development Templates (RDT) and Supplemental Data Requests (SDR).  Applies analytics and research to healthcare related topics such as homelessness, inpatient hospitalization, and chronic disease to determine financial implications and areas for potential cost savings/improvement.  Works collaboratively with staff in Finance/Accounting in the ongoing analysis and reporting of all aspects of the income statement and other operating metrics.
Job ID
2021-1921
FLSA Status
Exempt
Job Locations US-CA-Fairfield | US-CA-Redding
Part of a multidisciplinary team, responsible for clinical oversight of assigned grievance and appeal cases. Utilizes clinical judgement in the assessment, solution, and/or guidance of cases to ensure members receive high quality healthcare services. Working closely with PHC Medical Directors, oversees assessments for medically necessary determinations, quality of care concerns, allegations of abuse, fraudulent acts or wasteful activity. Provides clinical leadership to Grievance & Appeals Case Analysts to ensure clinical solution followed on casework. Ensures casework complies with DHCS guidelines, NCQA standards, and PHC best practices. Works independently, prioritizes case deliverables, remains customer-focused and stays current on changes in the healthcare system that may trigger member dissatisfaction. This position is eligible for teleworking.
Job ID
2021-1919
FLSA Status
Exempt
Job Locations US-CA-Fairfield
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.
Job ID
2021-1892
FLSA Status
Exempt
Job Locations US-CA-Fairfield
Manage daily operations of the Member Services Call Center and Enrollment Unit, including personnel and operational responsibilities.
Job ID
2021-1871
FLSA Status
Exempt
Job Locations US-CA-Fairfield
To assist and support the Director with development, implementation, and maintenance of professional, facility, and ancillary contracts for the PHC provider network. The Contracts Coordinator II is responsible for, Contracting Department tracking, and reporting provider network activities, including of scanning contract documents, mailing or emailing network notices related to contracting, initiating contracts and supporting daily contracting activities as assigned by Director. Provide administrative support to Director as needed.
Job ID
2020-1852
FLSA Status
Non-Exempt