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Pacific Health Group
Pacific Health Group
51 – 200 Angajați
Asistență medicalăImpact socialStare de bine
Pacific Health Group este o organizație de sănătate axată pe comunitate, care sprijină populațiile insuficient deservite prin programe integrate de îngrijire medicală, sănătate comportamentală și asistență socială. Activitatea sa include gestionarea îmbunătățită a îngrijirii pentru persoanele cu nevoi complexe, tratamentul pentru probleme de sănătate comportamentală și consum de substanțe, acțiuni de informare desfășurate de lucrători comunitari din domeniul sănătății, medicină stradală pentru persoanele fără adăpost, sprijin în domeniul locuirii și transport medical pentru persoanele care nu se pot deplasa. Colaborând cu planuri de sănătate și parteneri comunitari din mai multe locații, organizația adoptă o abordare holistică pentru îmbunătățirea sănătății, accesului și echității.
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Locurile de muncă ale companiei

Remote Data Administrator, Healthcare

Maintain accurate member records, health plan submissions, authorizations, and leadership reports for Pacific Health Group’s community healthcare programs. Support compliance, quality improvement, and research for program expansion.

USStatele Unite ale AmericiiKSKansasNVNevadaOHOhioWAWashington
49.920 $ – 56.160 $ / an
RemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăAdministrație

Descriere

  • Coordinate recurring ECM report and outreach file submissions to contracted health plans.
  • Collect, validate, and combine member data from internal systems.
  • Check submissions for health plan formatting and regulatory compliance.
  • Track submission deadlines and resolve errors or rejections.
  • Verify member eligibility regularly and review service enrollment with case managers.
  • Record requalification work and update member statuses.
  • Process initial and renewed authorizations through provider portals.
  • Monitor authorization approvals, denials, and upcoming renewals.
  • Transfer Lead Care Manager notes from TheraPlatform to SalesMate.
  • Apply consistent note formatting and audit data for accuracy.
  • Prepare weekly member status updates and reports for leadership.
  • Monitor patterns in outreach, reassessments, engagement, service use, and eligibility.
  • Update member profiles, discharge reasons, service end dates, and transition records.
  • Contribute to compliance work, internal audits, and quality improvement.
  • Research demographic, economic, healthcare utilization, regulatory, and community information to support program expansion.
  • Develop databases of prospective partners, community events, and outreach opportunities.
  • Identify and coordinate community events, conferences, and networking opportunities.
  • Measure post-event outcomes and engagement.
  • Support data implementations and migrations, workflow redesign, audits, and compliance reviews.
  • Help onboard and train staff in data procedures, systems, and reporting practices.
  • Partner with IT to resolve system issues and improve workflows.

Cerințe

  • Bachelor’s degree in data management, healthcare administration, information systems, or a related field; equivalent experience may be considered.
  • Healthcare data administration, reporting, or compliance experience is strongly preferred.
  • Proficiency with CRM platforms, reporting dashboards, and data entry tools.
  • Familiarity with TheraPlatform and SalesMate is a plus.
  • Strong analytical, organizational, and problem-solving abilities.
  • Clear communication with executives, managers, and cross-functional teams.
  • Familiarity with Medi-Cal, ECM, CalAIM, and health plan compliance processes is preferred.

Beneficii

  • 160 hours of paid time off.
  • 12 paid holidays annually, including a birthday holiday and, after one year, one floating holiday.
  • Four paid volunteer hours per month.
  • Bereavement leave, including pet bereavement.
  • 90% employer-paid medical coverage for employees only.
  • Flexible Spending Account (FSA).
  • Short-term and long-term disability coverage, plus AD&D.
  • Employee Assistance Program (EAP).
  • 401(k) with company match.
  • Monthly stipend.
  • Professional development and internal growth opportunities.
  • Employee discounts through Great Work Perks and Perks at Work.
  • Quarterly in-person events.

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