To prepare, analyze, report, and manage data used for both plan-wide and regional decision making for evaluating performance in key quality measures and the effective use of health plan resources on a routine and ad hoc basis. Works collaboratively with departments company-wide to identify data needs, develop and maintain data queries and tools, and complete accurate reporting to support performance and process improvements. Project/program involvement may include Partnership’s Healthcare Effectiveness Data Information Set (HEDIS) reporting initiative, Partnership Quality Dashboard (PDQ), Partnership’s provider pay-for-performance programs, and others as assigned.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives.

To plan, organize, manage, and implement projects.

The Manager of Vendor Oversight: D-SNP supports sourcing, contract execution, and performance management for vendor partners that directly support Partnership Advantage Dual Eligible Special Needs Plan (D-SNP). This position is responsible for relationship management with assigned vendors, as well as oversight of the contractual performance, maintenance of the vendor to ensure performance and compliance, building governance structures (JOC/AOC), implementing performance monitoring frameworks and ensuring all vendors meet regulatory and operational requirements during D-SNP implementation and after go-live. This position will be responsible for building relationships with business owners across the organization including:...

To provide high-level support for day-to-day PC operations, production operations support, systems and telecommunications support. Supports and leads all help desk functions with PC troubleshooting, performing software updates and maintaining the inventory of PC’s and network systems hardware. Serves as the primary, secondary, and/or tertiary level escalation point for desktop, VoIP, A/V, and connectivity support to internal customers/end users. Supports IT Operations efforts in the building, implementation, testing, and deployment of new servers, software, systems, network, and security changes. Primary operations support to production environment, maintains necessary skills related to production...

The Coordinator II will coordinate assigned departmental projects and provide complex administrative support to department leaders. Develops, implements and monitors processes, tools, and systems for collecting, tracking and managing information required for monitoring performance and deadlines. Develops and produces reports. In addition to the Coordinator I

To coordinate application request review meetings with IT Leadership, maintain detailed schedule of IT projects, provide project status reports, oversee the application request process and ensure that System Development Life Cycle (SDLC) process is followed.

To oversee the appropriateness and quality of care delivered through Partnership HealthPlan of California and for the cost-effective utilization of services.

The Coordinator II will coordinate assigned departmental projects and provide complex administrative support to department leaders. Develops, implements and monitors processes, tools, and systems for collecting, tracking and managing information required for monitoring performance and deadlines. Develops and produces reports. In addition to the Coordinator I

  Manages day-to-day operations of transportation services and benefits offered by Partnership HealthPlan of California (Partnership). Provides leadership, support, and education to assigned staff, and maintains relationships with providers, Partnership contracted vendor(s), community partners, and county agencies, to promote collaboration and ensure smooth and consistent application of Partnership transportation benefits. Participates in various internal venues to enhance cooperation and understanding of how the transportation program interacts with other...

The Configuration Quality Assurance Analyst I is responsible for auditing of Configuration Analyst I and Configuration Specialists on system related job functions. Performs retrospective, concurrent, and special configuration audits. Collaborates with Configuration Technical Development and Quality Assurance teams to identify audit trends and staff training.

To analyze and interpret financial data and procedures to prepare financial information and reports. Applies generally accepted accounting principles and procedures (GAAP) to record, classify, and examine financial transactions. Participates in Month End Close responsibilities such as journal entry creation to book expenses and accruals, uploads these items to accounting system and reconciling sub ledger accounts. Participates in annual financial audit by preparing requested audit schedules and responding to ad hoc audit requests. Responds to customer base (i.e. employees, outside vendors, members) in a timely and professional manner

To coordinate medically necessary behavioral health treatment services for adults and children with behavioral health needs. Screens, collaborates and coordinates care as part of the multidisciplinary team to evaluate and advocate for the medical, behavioral and psychosocial needs of the member while promoting quality outcomes.

To provide coordination and implementation support of defined tasks for the assigned program(s).

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

This position works with the Benefits team to administer the entire Employee Benefits Program, Workers’ Compensation Program, Benefits Open Enrollment Program, and Partnership sponsored Employee Life Insurance. The Benefits Coordinator is responsible for providing a full range of HR customer service support. This position also performs general HR benefits duties such as

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.

The AV Support Technician will help implement and maintain regional video collaboration tools to support Partnership HealthPlan’s communication needs. This role involves assisting with setup, basic troubleshooting, and providing support to staff and team members using AV equipment. The AV Support Technician will work closely with the AV Support Specialist and will be instrumental in ensuring consistent, high-quality AV experience throughout the organization.

The AV Support Technician will help implement and maintain regional video collaboration tools to support Partnership HealthPlan’s communication needs. This role involves assisting with setup, basic troubleshooting, and providing support to staff and team members using AV equipment. The AV Support Technician will work closely with the AV Support Specialist and will be instrumental in ensuring consistent, high-quality AV experience throughout the organization.

EDI Lead Programmer Analyst  Commission on Medical Care (DBA Partnership HealthPlan of California) is recruiting for our Fairfield, CA office: EDI Lead Programmer Analyst: Responsible for application maintenance and development which entails coding, testing, debugging and documenting new or modified software applications based on business requirements; utilizing languages such as C#, .NET, Python, JavaScript, or SQL; and maintaining...