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 plan, organize, manage, and implement projects.

Under direction from the Director of Care Coordination, manages and provides direction to the Care Coordination (CC) Department’s Clinical Integration Team’s Managers, Supervisors, and Individual contributors. A key component of this position is the enhancement and refinement of existing programs, and enthusiastic innovation in the development, management, integration, and refinement of new and existing programs. The Associate Director of Clinical Integration identifies and communicates opportunities aligned with strategic initiatives, market, stakeholder, and regulatory needs. This position is a critical intersection of identification and intake of clinical, regulatory, and business needs from internal and external...

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

To design, support, and provide strategic planning of the Business Intelligence solution across the enterprise. Manages deployment, maintenance, and support of Business Intelligence tools and reports. Analyzes, creates, documents, tests, maintains, troubleshoots, and promotes the Business Intelligence environment.

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.

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.

To assist in the day-to-day operations and management of the Member Services Department. Provides leadership and support and direction to Member Services staff.

Train examiner and customer service level I staff on all related claim types for all PHC lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.

Under the general supervision of department leadership, the Quality and Training Supervisor will lead the design and structure of the department’s Quality Assurance (QA) and training program. Responsibilities include: designing, developing, implementing, and managing all quality and training activities for the department. Additionally, the supervisor is responsible for driving the attainment of quality metrics and to achieve superior results. Through demonstrated individual performance, the Quality and Training Supervisor shall promote the highest standards of ethical and professional conduct to lead staff members by example.

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.

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 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.

To design, install, configure, implement, and support all aspects of infrastructure environments, providing technical guidance and oversight and acts as a point of escalation and technical support. Responsible for server farms’ uptime, production maintenance, roll-out of new servers, and other critical deployments. Responsible for assisting in the support of PHC’s server applications, web servers, database servers, fax server, VOIP infrastructure, UNIX/Amisys systems environment, Pure storage array based SAN environment and other application servers, as determined by the Director of Network Operations. Assist senior team members with network, related hardware devices, and other...

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...

Provides a range of social work services as a county child welfare liaison in collaboration with Partnership staff to meet the psycho-social and care coordination needs of members involved in the child welfare system. Responsible for the assessment and care coordination of the psychosocial needs of these 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.

To provide daily oversight, leadership, support, training and direction of both clinical and non-clinical staff. Supports and assists the Team Manager in developing and maintaining a cohesive team with a high level of productivity and accuracy to achieve the department's overall performance metrics. Designs and implements high quality, cost-effective care plans to enable members to achieve health goals.

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.

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.