This position will assist in the management of hardware, software and licensing. Additionally they will work to ensure all procedures are followed in the purchasing of hardware, software and licenses. The person in this position will analyze system data, prepare purchase orders, solicit bid proposals and review requisitions. This position will ensure all IT purchases are completed in a timely manner, in compliance with current Partnership HealthPlan of California (PHC) purchasing and contracting policies, and in alignment with IT and PHC strategic plan. This position will also work with the Chief Information Officer (CIO) and/or designee in the review

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.

To plan, organize, manage, and implement projects.

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.

To lead and participate in the development of complex software systems and programs at Partnership. Collaborates with the IT Director in the analysis, design, programming utilizing specifications and applying programming standards, troubleshooting, problem resolution, maintenance, and documentation of software systems and programs. Oversees all aspects of

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 as well as other staff within the department. The Health Care Guide II exercises a high degree of judgment, discretion, initiative, consistency and independence when working with members, families, providers, community agencies, and/or the interdisciplinary team.

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 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 duties, the Coordinator II may handle escalated calls, escalated Helpdesk inquiries, and may follow up with providers regarding missing documentation.

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 develop, implement, improve, and manage assigned programs. In addition to the Program Manager I duties, the Program Manager II has a higher level of experience, more autonomy, exercises independent judgement, and conducts business analysis and program analytics. Programs are ongoing, which may include aligned projects and requires strategic planning and continuous improvement efforts after program startup. Participates in the design, implementation, and/or expansion of strategic programs and departmental initiatives. Develops and delivers program goals, measures, and reports.

To provide administrative support to the department head, leadership teams, and staff as assigned. In addition to the Administrative Assistant I duties, the Administrative Assistant II has a higher level of experience and more autonomy, is involved in project coordination, identifies necessary efficiencies, and is exposed to confidential information.

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 duties, the Coordinator II may handle escalated calls, escalated Helpdesk inquiries, and may follow up with providers regarding missing documentation.

To assist in the negotiation, development, implementation, and maintenance of new and existing professional, facility, and ancillary contracts for the PHC provider network. The Contract Specialist II will also be responsible for supporting daily contracting activities as follows:

To assist in the negotiation, development, implementation, and maintenance of new and existing professional, facility, and ancillary contracts for the PHC provider network. The Contract Specialist will also be responsible for supporting daily contracting activities as follows:

The Senior Director of Quality and Performance Improvement is a key individual on PHC’s Senior Leadership Team and is responsible for leading a growing Quality Department at Partnership HealthPlan of California (PHC) through quality and performance improvement activities to substantially improve the quality of care provided to PHC members.

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.

To gather and validate healthcare practitioner credentialing information in accordance with regulatory and accreditation standards. Interacts with practitioners by phone to ensure timely receipt of information. Responds to inquiries via telephone and email.

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.

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

    To provide administrative support to the department head, leadership teams, and staff as assigned. In addition to the Administrative Assistant I duties, the Administrative Assistant II has a higher level of experience and more autonomy, is involved in project coordination, identifies necessary efficiencies, and is exposed to confidential information.