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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 administrative support to the department head, leadership team, and staff as assigned.
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 support and/or lead in planning, organization, management, and implementation of projects. In addition to the Project Coordinator I duties, a Project Coordinator II has a higher level of experience, works well with ambiguity and is expected to work with more autonomy on assignments
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 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.
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 oversee the appropriateness and quality of care delivered through Partnership HealthPlan of California and for the cost-effective utilization of services.
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.
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.
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 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
The Accountant II (AP Specialist) provides support for Business Office functional areas with
specific responsibility for performing activities related to the timely and accurate payment of
authorized check requests/invoices while providing excellent customer service to our employees,
vendors, suppliers and healthcare providers. Accountant II is distinguished from Accountant I by
the complexity of tasks that require a higher level of analytical, problem solving and perform
duties and tasks independently.
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.