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Nursing and Allied Health Success Specialist Cuesta College Salary: $64,008.00 - $77,796.00 Annually Job Type: Job Number: FY2526-00062 Location: San Luis Obispo &amp; North County Campus, CA Department: Instruction Closing: 11/17/2025 11:59 PM Pacific Job Description Summary DEFINITION Under general direction of the Director of Nursing, implements activities and promotes nursing and allied health student success benchmarks of on-time program completion, passing licensure exams, and gaining prompt employment in nursing and allied health careers; gathers and compiles data for regulatory reports; implements assessment testing for program applicants; provides program eligibility requirements to interested applicants; and performs other duties as required. DISTINGUISHING CHARACTERISTICS The Nursing and Allied Health Academic Success Specialist is distinguished from other positions by the requirement to oversee the development, implementation, evaluation, and reporting of Nursing and Allied Health program retention, student remediation, and grant project outcomes. The Academic Success Specialist will provide services and support necessary to meet program outcomes and to increase student success and retention. Incumbents in this position support student learning outcomes by working with all students to be successful in the Nursing and Allied Health programs, and by developing, implementing, and maintaining an intervention program to increase at-risk students' ability to be successful in the Nursing and Allied Health programs. ABOUT THE COLLEGE Where You Will Work Serving all of San Luis Obispo County, Cuesta College has provided comprehensive associate degree offerings, certificates, and community programs to the region since 1964. The main campus is located along scenic Highway 1, west of San Luis Obispo and east of the beaches of the Pacific Ocean. Cuesta College has a North County Campus in Paso Robles, and South County Center, in Arroyo Grande. Who We Are Equity, diversity, and inclusion are essential to our culture and the work we do. Cuesta College is proud to be a designated Hispanic-Serving Institution (HSI) committed to racial and socio-economic diversity as it reflects our communities and student populations. We actively seek to attract candidates who share this commitment to equity, diversity, and inclusion. As part of the Cuesta College team, you can expect to be part of a collaborative community of faculty, classified professionals, administrators, students, and community partners advancing educational excellence with intentional support services leading to student success and completion. 
<ul>
<li>Additional information about the college can be found at<a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/index.html" target="_blank">https://www.cuesta.edu/about/index.html</a></li>
<li>The college planning documents can be found at<a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/collegeplans/index.html" target="_blank">https://www.cuesta.edu/about/collegeplans/index.html</a></li>
<li>Our Student Equity Action Plan can be found at<a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/info/student-equity-initiatives/equity/index.html" target="_blank">https://www.cuesta.edu/about/info/student-equity-initiatives/equity/index.html</a></li>
<li>We offer comprehensive benefit options. Information about benefits can be found at<a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/depts/benefits-insurance/index.html" target="_blank">https://www.cuesta.edu/about/depts/benefits-insurance/index.html</a></li>
</ul>
 Essential Functions &amp; Qualifications ESSENTIAL FUNCTIONS 
<ul>
<li>Work closely with the Director of Nursing and the Associate Director of Allied Health to provide support for program applicants, enrolled students, and graduates of the Nursing &amp; Allied Health programs on both the San Luis Obispo and North County campuses;</li>
<li>Coordinate with the Director of Nursing, applicant assessment testing and remediation plans for students not meeting the benchmark to increase their ability to become eligible applicants;</li>
<li>Gather, analyze, and maintain statistical and student demographic data using paper and integrated software systems for required college, grant, and regulatory reports;</li>
<li>Prepare and implement student and healthcare agency surveys;</li>
<li>Use available technologies to compile data and write reports to meet deadlines;</li>
<li>Participate in planning and implementing the evaluation process of grant projects;</li>
<li>Assist in the preparation and implementation of informational meetings and workshops for interested applicants;</li>
<li>Perform specialized work duties as necessary during program application cycles and incoming student orientations;</li>
<li>Work closely with the program directors and faculty to identify, monitor, follow up with students in academic jeopardy of not meeting theory and clinical course and program objectives; </li>
<li>Develop and implement student success, retention and remediation strategies using appropriate college and community resources;</li>
<li>Research and cultivate scholarship opportunities for students;</li>
<li>Participate and promote activities to increase students' confidence and knowledge to take and pass licensing or certificate exams;</li>
<li>Assist with Nursing and Allied Health job fairs;</li>
<li>Attend Division faculty and level meetings as required;</li>
<li>Assist in annual revisions of program applications and student handbooks;</li>
<li>Support the program directors with duties as assigned for program completion ceremonies; </li>
<li>Coordinate mentoring programs as needed for Nursing &amp; Allied Health students;</li>
<li>Participate in outreach activities as assigned;</li>
<li>Assist with the general clerical duties of the Nursing and Allied Health Division, including the development of confidential correspondence, reports, flyers, program handbooks, and orientation materials</li>
<li>Communicate effectively orally and in writing; </li>
<li>Establish and maintain cooperative working relationships;</li>
<li>Demonstrate a sensitivity to and understanding of the diverse academic, socioeconomic, cultural, and ethnic backgrounds of staff and students and of staff and students with physical and learning disabilities;</li>
<li>Apply policies, procedures, and practices of the College with sound judgement; and,</li>
<li>Perform other related duties as required.</li>
</ul>
 Duties may require the physical ability to: 
<ul>
<li>Work with a high degree of independence to oversee programs, including recruitment and outreach/marketing strategies;</li>
<li>Organize and carry through on assignments and projects;</li>
<li>See for the purpose of reading laws, codes, rules, policies and other printed matter;</li>
<li>Hear and understand speech at normal levels;</li>
<li>Speak so that others will be able to understand a normal in-person and telephone conversation;</li>
<li>Sit or stand for extended periods of time;</li>
<li>Lift and/or carry 25 pounds;</li>
<li>Manual dexterity sufficient for keyboard and other office equipment operation.</li>
</ul>
 QUALIFICATIONS Education: Required 
<ul>
<li>Associates Degree in a field related to the position; or</li>
<li>Equivalent combination of education and experience</li>
</ul>
 Preferred 
<ul>
<li>Bachelor's Degree in field related to the position; or</li>
<li>Equivalent combination of education or experience</li>
</ul>
 Experience: Preferred 
<ul>
<li>Three years experience working with community college students or in a related healthcare discipline or in case management </li>
</ul>
 Knowledge of: 
<ul>
<li>Training and educational requirements for health care related occupations, especially RN;</li>
<li>Understanding, interpreting and applying federal, state, and district rules, regulations, procedures and policies which pertain to Nursing and Allied Health recruitment, training and retention;</li>
<li>Effective communication and interaction with persons of diverse background and abilities;</li>
<li>Local health care industry needs;</li>
<li>Current technologies, personal computer, and associated office software such as word processing, spreadsheet, presentation, and/or database software;</li>
<li>Correct usage of English, grammar, spelling, punctuation, and vocabulary;</li>
<li>District policies and procedures</li>
</ul>
 Additional Information Work on both the SLO and NCC. Hours varied with summer and evening classes of students attending the NAH courses. REQUIRED DOCUMENTS TO APPLY Candidates will be required to submit ALL of the required documents below when applying for this position. When uploading documents, PDF uploads are preferred. 
<ol>
<li>Resume;</li>
<li>Associates Degree in a related field or equivalent combination of education and experience preferred</li>
<li>Diversity statement (see further instructions below). </li>
</ol>
 Diversity Statement Instructions: Cuesta College is committed to building and maintaining a workforce that reflects and honors the diversity of our students. It is important to us that our faculty, staff, and administrators demonstrate an understanding of, sensitivity to, and respect for the diverse academic, socioeconomic, ethnic, and religious backgrounds as well as sexual orientation and abilities of all constituents in the Cuesta College community. In 500 words or less, with consideration to our Mission Statement and our values expressed above, please explain how you will demonstrate your commitment to diversity, equity, and inclusion in this position. Completed online applications and all supporting documents must be submitted by the closing date for this position. LATE, INCOMPLETE, FAXED, MAILED OR EMAILED APPLICATIONS WILL NOT BE ACCEPTED. ADDITIONAL INFORMATION Cuesta College will not sponsor any visa applications. San Luis Obispo County Community College District ("Cuesta College") is an equal opportunity employer committed to nondiscrimination on the basis of race, ethnicity, color, religion, national origin, sexual orientation, gender, gender identity, gender expression, marital status, medical condition, pregnancy (including pregnancy, childbirth, and medical conditions related to pregnancy or childbirth), age, disability (physical and mental), genetic information, military and veteran status, or any other characteristic protected by applicable federal and state law in admission and access to, or treatment in employment, educational programs or activities at any of its campuses. Reasonable accommodations will be provided for applicants with disabilities who self-disclose. Cuesta College also prohibits harassment on any of these bases, including sexual harassment, as well as sexual assault, domestic violence, dating violence, and stalking. In compliance with California law, all prospective staff and students are entitled to read the Annual Security Report, published each October by the Cuesta College Department of Public Safety. This report contains information about our emergency and crime reporting procedures, as well as crime statistics for the past 3 years. You may request a copy of this report at one of our two Public Safety Offices: on SLO campus at Building 6600A or on North County Campus at building N1021, during campus business hours. You may also access the complete text of this report at the following website address: <a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/depts/publicsafety/clery_act" target="_blank">https://www.cuesta.edu/about/depts/publicsafety/clery_act</a> Cuesta College uses E-Verify as part of the I-9 process to verify the work eligibility of all new hires. E-Verify is an Internet-based system that compares information from an employee's Form I-9 to data from U.S Department of Homeland Security and Social Security Administration records. For further information, visit: <a href="https://apptrkr.com/get_redirect.php?id=6695884&amp;targetURL=https://www.cuesta.edu/about/depts/humanresources/Job_Opportunities.html" target="_blank">https://www.cuesta.edu/about/depts/humanresources/Job_Opportunities.html</a> Interview Process Information Selected applicants will be invited to attend an in-person interview on Thursday, December 11, 2025. To be considered for this position please visit our web site and apply on line at the following link: <a href="https://apptrkr.com/6695884" target="_blank">https://www.governmentjobs.com/careers/cuesta</a> The San Luis Obispo County Community College District promotes inclusiveness, prohibits discrimination, and encourages all qualified persons to apply. As an Equal Employment Opportunity Employer, Cuesta College actively seeks candidates with diverse backgrounds to assist students, staff, and faculty. For ADA (Americans with Disabilities Act) assistance with the application and/or interview process, please contact the Human Resources Office: (805) 546-3129. Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-4eefd19363198c43a1b4a6a97927c5cd

Nursing and Allied Health Success Specialist

Pharmacy Resident CalOptima Join Us - Where Your Talent Meets Opportunity. We're Better Together The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Pharmacy Resident and help shape the future of healthcare where you'll be an integral part of our Pharmacy Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. The Pharmacy Residency Program at CalOptima Health is a non-accredited managed care residency that provides a unique opportunity to gain valuable clinical and administrative experience in an integrated managed care setting. You will be trained in the role of the Clinical Pharmacist in developing and implementing formulary administration, medication use management, pharmacy benefit design, pharmacy network management, pharmacy benefit management relationship and drug-use policy development. You will also be trained to function as a leader in developing and implementing pharmaceutical care plans for specific patients in an integrated health plan and delivery system setting. Clinical experiences include but are not limited to, face-to-face and/or telephonic Comprehensive Medication Review (CMR) sessions as a part of the in-house Medication Therapy Management (MTM) program, Interdisciplinary Care Team (ICT) meeting participation, involvement in the Program of All-Inclusive Care for the Elderly (PACE), coverage determination training, prior authorization criteria development and medication profile reviews for identified high-risk patients. Administrative experiences include training in CalOptima Health's policies and procedures and learning the relationship managed care organizations have with the community pharmacy provider network, physician provider network and the pharmacy benefit manager (PBM). Throughout the year, you will have the opportunity to attend various meetings, such as CalOptima Health's quarterly Pharmacy &amp; Therapeutics (P&amp;T) meeting and other quality improvement meetings. These experiences will provide you with valuable insight into the patient and quality-centered approach to managed care at CalOptima Health. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Designs and implements clinical programs to enhance the efficacy of patient care.</li>
<li>Ensures the safety and quality of the medication-use system.</li>
<li>Provides medication and practice-related information, education and/or training.</li>
<li>Designs effective benefit structures to service specific population's needs.</li>
<li>Completes a residency project, which may be in the form of original research, a problem-solving exercise or development or enhancement of some aspect of our pharmacy services.</li>
<li>Delivers a formal presentation of the residency project at the annual Western States Pharmacy Conference.</li>
<li>Precepts pharmacy interns on rotation at CalOptima Health. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other duties and projects as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Doctor of Pharmacy (PharmD) degree from a fully accredited university required. </li>
<li>Eligibility for licensure in California by July 1, of the program year start date, and licensure obtained within one hundred twenty (120) calendar days of entering the residency program. </li>
<li>Have access to means of transportation for work away from the primary office approximately 10% of the time required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese). </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>n/a</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment less than 10 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 305 - $55,966 - $83,949 ($26.91 - $40.3601). 
<ul>
<li>The base pay offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6695589&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is January 5, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6695589" target="_blank">https://jobs.caloptima.org/jobs/pharmacy-resident-505-city-parkway-west-california-united-states-2b98ad32-441b-4522-9852-e8b83260fdef</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-84a2aeafa7bf7f4ebae137273a890c61

Pharmacy Resident

Grants Payment Manager/Senior Grants Payment Manager The Simons Foundation is seeking a Grants Payment Manager/Senior Grants Payment Manager (dependent upon experience level and qualifications). This position is responsible for managing all aspects of the payments process for the Simons Foundation and the Simons Foundation International, within our grants management system, the Simons Award Manager (SAM). In 2024, this included processing 3,165 payments totaling over $486 million, as well as scheduling over $400 million in new commitments across 844 awards for both funding entities. The Grants Payment Manager/Senior Grants Payment Manager oversees the scheduling and approval of all grant and gift-related payments. They manage payment modifications and holds, and ensure compliance with the foundation's policies, including carry-forward requirements and the unspent funds process. The Grants Payment Manager/Senior Grants Payment Manager also oversees the administration of over 600 Institution Profiles across 30 countries, which includes the oversight of contacts and user administration and the submission and approval of banking details. They are also responsible for all payment and institution-related reporting. The role requires strong collaboration across internal teams and with external grantees. This position will report to the Vice President, Grants Management and currently manages two Grants Payment Assistants. This position is a full-time position based on-site at the Simons Foundation's New York City offices. Visit the <a href="https://apptrkr.com/get_redirect.php?id=6682236&amp;targetURL=https://www.simonsfoundation.org/careers/" target="_blank">Simons Foundation career page</a> to learn more. ESSENTIAL FUNCTIONS/RESPONSIBILITIES 
<ul>
<li>Oversees all aspects of the monthly payment process, including the submission and approval of payment details, the scheduling of payments, the modification of payments, and the resolution of payment-related holds. </li>
<li>Manages Institution Profiles, which include automated clearing house and wire transfer payment details, as well as contacts and user information for the institutions. </li>
<li>Reviews and approves Authorized Institution Officials responsible for submitting payment details. </li>
<li>Produces all grant-related reports, including the monthly payment schedule, quarterly and annual reconciliations and reports, and other reports as needed. </li>
<li>Reconciles payment data in the Simons Award Manager (SAM) against the finance department's records to ensure accuracy. </li>
<li>Builds strong relationships with other departments at the foundation, most importantly the finance and business information technology departments. </li>
<li>Continually improves payment process workflows, reporting, and related standard operating procedures. </li>
<li>Serves as a key representative of the grants department in cross-functional meetings regarding payment policies and processes. </li>
<li>Acts as the subject-matter expert for payment functions, providing guidance, best practices, and risk analysis for SAM. </li>
<li>Creates payment-related deliverable templates, instructions, and FAQs for internal and external use. </li>
<li>Oversees the payment deliverable submission and review process, ensuring timely and accurate processing. </li>
<li>Ensure grantee compliance with unspent funds, carry-forward policies, and other payment-related requirements. </li>
<li>Manages and provides guidance to two Grants Payment Assistants, ensuring accurate and timely execution of their responsibilities. </li>
<li>Performs any other duties or tasks as assigned or required.</li>
</ul>
 MINIMUM QUALIFICATIONS Education 
<ul>
<li>Bachelor's degree</li>
</ul>
 Experience 
<ul>
<li>At least 5-8 years of experience in grants administration, financial operations, or a similar role, preferably in a nonprofit, foundation or research institution setting. </li>
<li>Experience with reconciling financial data is essential. </li>
<li>Experience managing staff, delegating tasks, and mentoring team members.</li>
</ul>
 Related Skills &amp; Other Requirements 
<ul>
<li>Ability to work independently and manage others </li>
<li>Superb Excel and PowerPoint skills </li>
<li>Strong attention to detail </li>
<li>Excellent interpersonal skills </li>
<li>Exceptional written and verbal communication skills </li>
<li>The ability to complete multiple tasks while working under deadlines with competing priorities </li>
<li>Familiarity with grant management systems (like SmartSimple, ProposalCentral, or similar) is a plus.</li>
</ul>
 COMPENSATION AND BENEFITS 
<ul>
<li>The full-time annual compensation range for this position is $90,000 - $135,000, depending on experience level and qualifications. </li>
<li>In addition to competitive salaries, the Simons Foundation provides employees with an outstanding benefits package.</li>
</ul>
 REQUIRED APPLICATION MATERIALS 
<ul>
<li>Please submit a resume and cover letter stating your interest in the position.</li>
</ul>
 Our Commitment to Expanding Pathways to Science &amp; Opportunities for All: Many of the greatest ideas and discoveries come from a diverse mix of minds, backgrounds, and experiences. The Simons Foundation is committed to advancing basic science and mathematics to benefit humankind and expand our collective understanding of our world. As part of our mission, we support partners, programs, and initiatives that seek to broaden the scientific community and open pathways to science and mathematics careers. The Simons Foundation provides equal opportunities to all applicants without regard to race, religion, color, age, sex, pregnancy, national origin, sexual orientation, gender identity, genetic disposition, neurodiversity, disability, veteran status, or any other protected category under federal, state, and local law. To apply, please visit: <a href="https://apptrkr.com/6682236" target="_blank">https://simonsfoundation.wd1.myworkdayjobs.com/en-US/simonsfoundationcareers/details/Grants-Payment-Manager-Senior-Grants-Payment-Manager_R0001973</a> Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-831cdee1a00c2b46b9cdf1876a0e06cd

Grants Payment Manager/Senior Grants Payment Manager

Program Specialist (Sales) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Program Specialist (Sales) and help shape the future of healthcare where you'll be an integral part of our OneCare Sales &amp; Marketing team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Under general supervision, you will assist and support the Director of Sales and Marketing in a wide variety of duties related to broker support. You will work closely with the director to support agents and brokers, including certification, email and phone support and supply requests. Additionally, you will oversee the agent broker payment process. You will also will be responsible for assisting in the research of sales allegations, Complaint Tracking Module (CTM) complaints, grievances, preparing reports, commission reports, submitting check requests to accounting, supporting agent/broker processes and coordinating events related to broker activities. Lastly, you will interface and work collaboratively with internal staff, agents/brokers and providers to ensure that policies and procedures meet regulatory requirements for operations and support other key CalOptima Health provider relations staff on related projects. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Serves as the primary health plan support and point person with agent/brokers, other CalOptima Health departments for administrative functions of operating OneCare Health Maintenance Organization Dual Special Needs Plan (HMO D-SNP) Outreach and Education and Provider Relations departments.</li>
<li>Assists the team with quality checks for enrollment, disenrollment and payment processing to ensure the Field Marketing Organizations (FMO), independent agents, community partners and other vendors are compliant with all regulatory and CalOptima Health requirements in accordance with the agreement.</li>
<li>Participates in CalOptima Health workgroups to meet its contractual requirements with the Center for Medicare and Medicaid (CMS), California Department of Health Services (DHCS), Department of Managed Health Care (DMHC) and any other applicable entity.</li>
<li>Supports department staff to maintain health plan management operations, including staying updated with relevant CMS and Medi-Cal regulations and requirements.</li>
<li>Coordinates community events in support of member or provider outreach team functions.</li>
<li>Acts as liaison between CalOptima Health and the community to effectively resolve issues.</li>
<li>Prepares meeting materials, meeting set-up, minute taking, etc., as designated by the director.</li>
<li>Maintains an inventory of marketing, enrollment supplies, including monitoring needs and ordering for supplies, member material and promotional items for the Sales and Marketing department.</li>
<li>Coordinates delivery/shipment of marketing brochures and enrollment/sales kits for the FMO/broker agencies.</li>
<li>Monitors the agent support mailbox and dedicated phone number and responds to inquiries or redirects to appropriate staff or department for assistance.</li>
<li>Provides support for specific and/or ongoing projects, such as generating reports, logs, calendars and mailings, applying general business practices, as well as CalOptima Health policies and procedures.</li>
<li>Maintains confidential and sensitive information and files regarding management projects, policy and personnel, ensuring appropriate follow-up.</li>
<li>Participates in Audit and Oversight Committee meetings as needed. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree PLUS 1 year of work experience in health care administration with demonstrated or potential competence in working with health plan management functions required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Experience with agent/broker field organizations or broker agencies. </li>
<li>Experience in provider relations, Medicare or Medi-Cal enrollment and eligibility.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A </li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 305 - $55,966 - $83,949 ($26.91 - $40.3601). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687144&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 12, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687144" target="_blank">https://jobs.caloptima.org/jobs/program-specialist-sales-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-686bb121abedf041a5969a6f34bb8a09

Program Specialist (Sales)

Provider Relations Rep CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Provider Relations Rep and help shape the future of healthcare where you'll be an integral part of our Provider Relations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for assisting with provider relations and service interactions, including but not limited to developing and training external provider education programs, identifying gaps in network composition and services and assisting the network contracting staff in prioritizing contracting needs. You will ensure that all provider orientations, site visits, access and availability studies are completed within compliance and established time frames. Lastly, you will provide support with identifying and remediating operational shortfalls as well as researching and resolving claims. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Builds and maintains relationships with all network providers.</li>
<li>Performs outreach, monitoring and resolution of operational and/or contractual issues.</li>
<li>Identifies network gaps and performs recruitment to address community network needs.</li>
<li>Completes new provider orientation for all applicable product lines within the CalOptima Health community network.</li>
<li>Conducts site visits to service providers with training and education, resolves issues, educates and interprets staff/providers on policies and procedures, collects credentialing information and reviews Healthcare Effectiveness Data and Information Set (HEDIS) information.</li>
<li>Works with providers to ensure adherence to contract regulatory requirements and to communicate and meet the established CalOptima Health's strategic goals.</li>
<li>Represents CalOptima Health at community and health plan-sponsored events.</li>
<li>Creates and delivers presentations on various CalOptima Health topics to the provider community. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects or duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in business administration, health care administration or related field PLUS 2 years of experience in a health care or managed care setting required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>Valid driver's license and vehicle, an acceptable driving record and current auto insurance or other approved means of transportation, will be required for work away from the primary office 30% of the time or more.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>N/A</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 306 - $58,205 - $90,217 ($27.98 - $43.3736). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687106&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 11, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687106" target="_blank">https://jobs.caloptima.org/jobs/provider-relations-rep-505-city-parkway-west-california-united-states-78a29d52-ee45-4664-adfb-431e3f834bcf</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-04c14eabc0b916419c6c54b9f8ff2ccf

Provider Relations Rep

Program Manager (Quality Incentives) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Program Manager (Quality Incentives) and help shape the future of healthcare where you'll be an integral part of our Quality Analytics team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Under the general direction of the Director of Quality Initiatives, You will collaborate and coordinate with leadership to design, implement and evaluate quality incentive programs. You will support with leading, implementing and optimizing pay for value incentive programs across our provider and hospital network. You will interact with CalOptima Health's executives and management, legal counsel and state and federal regulatory agencies. Additionally, you will support CalOptima Health staff on related projects as needed. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>80% - Program Management
<ul>
<li>Leads end-to-end management of provider incentive programs, health network pay-for-value initiatives and hospital quality pay for value models.</li>
<li>Collaborates with cross-functional teams and vendors to develop program strategies and performance metrics.</li>
<li>Monitors quality incentive program performance, identifies improvement opportunities and implements data-driven enhancements.</li>
<li>Communicates program goals, progress and outcomes to internal stakeholders and external partners.</li>
<li>Participates in meetings with providers, health networks and hospital partners to review performance for quality measures and CalOptima Health's pay for value (P4V) programs.</li>
<li>Assists partners with understanding and implementing best practices to improve performance.</li>
<li>Assists in the implementation of quality improvement grant programs that utilize unearned incentive dollars.</li>
<li>Assists management in the development of specifications and scope of work for a Request for Proposal (RFP), Request for Quote (RFQ) or Request for Inquiry (RFI) to support new program development as needed.</li>
<li>Supports program design, development and implementation of quality programs impacting, but not limited to Healthcare Effectiveness Data and Information Set (HEDIS), Managed Care Accountability Sets (MCAS) and Centers for Medicare &amp; Medicaid Services (CMS) STARs quality measures consistent with the quality program and workplan.</li>
<li>Produces slide decks, summaries, root cause analyses, impact analyses and other reports as needed by leadership.</li>
<li>Applies analytical skills to evaluate data based on project specifications; requests and interprets data to support decision-making and communicates insights to cross-functional stakeholders.</li>
<li>Establishes key performance indicators (KPIs) and metrics to monitor project progress and performance, providing regular updates to senior management.</li>
<li>Leads performance and quality improvement projects, Plan Do Study Act or other formats as needed.</li>
<li>Reviews evidence-based literature for best practices to incorporate into strategy.</li>
<li>Develops and oversees the process of written tools for programmatic use, including program plans, surveys and evaluation instruments.</li>
<li>Maintains current knowledge of applicable regulations or clinical guidelines related to program development.</li>
<li>Stays current on the local, state and federal health care environment and identifies issues that may impact CalOptima Health's quality program and work plan. </li>
</ul>
</li>
<li>15% - Administration Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Reviews and assists in updating policies and procedures to ensure knowledge related to assigned programs and projects is kept up to date.</li>
<li>Works with all CalOptima Health departments in response to inquiries, problem-solving and promoting CalOptima Health's mission and message. </li>
</ul>
</li>
<li>5% -
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in healthcare or a related field required PLUS 3 years of experience in program development, program/project management or quality metrics analysis and improvement required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Master's degree in public health, health administration or related field. </li>
<li>1 year of experience working in a highly matrixed, mission-driven organization.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687168&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 11, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687168" target="_blank">https://jobs.caloptima.org/jobs/program-manager-quality-incentives-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-f798b55cf9658a43bbd24454ae6ef359

Program Manager (Quality Incentives)

Claims Examiner Sr CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Claims Examiner Sr and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for analyzing and validating claims elements and claims processing. You will adhere to regulatory and internal guidelines in conjunction with CalOptima Health's policies and procedures related to claims adjudication. You will be responsible for adjudicating more complex claims which require additional research or problem-solving. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Claims Support
<ul>
<li>Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.</li>
<li>Conducts research and problem solves the more complex claims.</li>
<li>Processes professional and institutional claim types.</li>
<li>Performs thorough review of pending claims for billing errors and questionable billing practices, including duplicate billing and unbundling of services.</li>
<li>Corrects system-generated errors manually prior to final claims adjudication.</li>
<li>Processes claims based upon CalOptima Health's contractual agreements or pricing agreements, applicable regulatory legislation, claims processing guidelines and CalOptima Health's policies and procedures.</li>
<li>Analyzes and validates Medi-Cal and/or Medicare claims pricing; researches, adjusts and adjudicates claims; reviews services for accurate charges, utilizing billing code sets and/or authorization guidelines as a reference.</li>
<li>Processes claim exception reports as assigned. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High school diploma or equivalent PLUS 2 years of related claims processing experience required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Experience processing online claims in a managed care environment. </li>
<li>Experience processing Medi-Cal and/or Medicare claims. </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 303 - $51,744 - $72,441 ($24.88 - $34.8274). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6692128&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 13, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6692128" target="_blank">https://jobs.caloptima.org/jobs/claims-examiner-sr-505-city-parkway-west-california-united-states-55768582-cbb1-4f0a-9b91-f24bd96b3864</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-0997c2453663f24f8553ce58bf644157

Claims Examiner Sr

College of Arts and Sciences Support Services CoordinatorClosing Date: Job Duties: The COAS Support Services Coordinator is responsible for coordinating academic, administrative, safety, and event-related functions across multiple departments and divisions within the college, while also providing direct support to the College’s Assistant Dean and faculty. ESSENTIAL FUNCTIONS: Faculty, Staff, &amp; Academic Division Support
<ul>
<li>Serve as the primary administrative support for all full-time and adjunct faculty across the College Provide direct support to the COAS Assistant Dean, including managing calendars, coordinating meetings, preparing agendas, and handling communications</li>
<li>Maintain curriculum records and assist with updates to plans of study, catalog entries, and syllabi collections</li>
<li>Compile semester course schedules for COAS based on submissions by Faculty Support Services Coordinators and coordinate with the Registrar’s Office to address initial room assignments and schedule changes</li>
<li>Collect, organize, and distribute faculty office hours in a matrix format for student reference and placement on the COAS website</li>
<li>Process forms including leave requests, course substitutions, grade changes, directed study approvals, and reimbursements using digital workflows (e.g., Box)</li>
<li>Maintain digital and physical records in accordance with institutional retention policies</li>
</ul>
 Event Coordination, Recruiting, &amp; Student-Facing Services
<ul>
<li>Coordinate logistics and provide administrative support for recruiting events, outreach activities, and academic ceremonies (e.g., Honors &amp; Awards)</li>
<li>Support faculty and students with communication related to class changes, cancellations, or academic updates</li>
<li>Maintain a welcoming and professional office presence for all students, visitors, and faculty</li>
</ul>
 Administrative Operations &amp; Systems Coordination
<ul>
<li>Maintain the COAS data management systems, including tracking, compiling, and analyzing data to support strategic planning and reporting</li>
<li>Monitor inventory and coordinate ordering of office and instructional supplies for COAS faculty and staff</li>
<li>Manage purchase order requests, vendor communication, and travel reimbursements in compliance with university procedures</li>
<li>Oversee shared equipment (copiers, printers, scantrons) and coordinate technical support or supply orders as needed</li>
<li>Submit and track work orders using eSpace for facilities, maintenance, custodial, and IT requests</li>
<li>Assist with budget-related tracking, planning documentation, and preparation of internal or external reports</li>
<li>Schedule classrooms and meeting rooms using eSpace and Zoom</li>
<li>Provide minute-taking recording for meetings in person and virtual meetings as needed</li>
<li>Use Banner 9 and other institutional systems for academic and procurement processes</li>
</ul>
 Lab Safety &amp; Risk Management Support
<ul>
<li>Support the Assistant Dean and Health and Life Sciences Division Head with safety and risk management initiatives across all COAS academic labs</li>
<li>Assist in tracking and maintaining documentation for Chemical Hygiene Plans and other safety protocols relevant to Natural Science Wet Labs and other lab environments</li>
<li>Submit and track safety-related work orders, equipment maintenance requests, and procurement of safety supplies or services</li>
<li>Serve as an administrative liaison to university safety/risk management offices and ensure lab documentation aligns with compliance requirements</li>
</ul>
 Cross-College Collaboration &amp; Continuous Improvement
<ul>
<li>Collaborate with other COAS administrative staff to ensure seamless communication, mutual support, and operational continuity</li>
<li>Provide coverage and administrative support for other divisions within the college as requested by the Assistant Dean</li>
<li>Participate in regular COAS administrative support meetings, contributing to shared knowledge and consistent practices</li>
<li>Engage in cross-training, onboarding, and mentoring of new administrative team members</li>
<li>Continuously assess and recommend improvements to workflows, systems, and processes that enhance efficiency, service quality, and compliance</li>
<li>Demonstrate professionalism, flexibility, and responsiveness in a dynamic academic environment</li>
<li>Complete other duties as assigned</li>
</ul>
 Required Qualifications: QUALIFICATIONS REQUIRED:
<ul>
<li>High school diploma or its equivalent required.</li>
<li>Ability to understand oral and written instructions required</li>
<li>Basic computer knowledge and experience required</li>
<li>Ability to organize and work independently required</li>
<li>Ability to communicate effectively and establish and maintain positive working relationships required</li>
</ul>
 OTHER QUALIFICATIONS AND JOB REQUIREMENTS: Preferred:
<ul>
<li>Bachelor’s degree with courses or experience in statistics, finance, information systems management, accounting, and/or math preferred</li>
<li>Experience in using Banner and Excel preferred</li>
<li>Experience with database software and Argos preferred</li>
</ul>
 WORKING CONDITIONS:
<ul>
<li>Must be able to remain in a stationary position, such as standing and/or sitting, for up to 75% of the time</li>
<li>Occasionally tasked with duties that require low postures such as crouching, kneeling, and/or stooping</li>
<li>Must be able to occasionally adjust or move objects up to 20 pounds in all directions.</li>
<li>Job frequently requires communication with others to exchange information</li>
<li>Frequently uses hands/fingers to operate a computer and other office productivity machinery, such as copier, printer, etc.</li>
<li>Frequently uses near vision for the use of computers and reading small print</li>
</ul>
 Salary Schedule: Salary Band: N290To view salary schedules, visit: <a href="https://www.athens.edu/about/offices/human-%20resources/salary-schedule-tables/" target="_blank">https://www.athens.edu/about/offices/human- resources/salary-schedule-tables/</a>Salary will be commensurate with experience and qualifications Special Instructions to Applicants Unofficial transcripts should be from the college or university which verifies qualifications for the position. Note: Credential evaluations are needed for all transcripts obtained outside the U.S. before uploading and submitting an application. (Credential evaluators should provide course-by-course evaluations and transcribed in English.) Upon an offer of employment, official transcripts from all colleges and universities attended must be submitted. Continued employment is contingent upon receipt of transcripts from all colleges and universities attended. To be considered for this position please visit our web site and apply on line at the following link: <a href="https://apptrkr.com/6659247" target="_blank">https://jobs.athens.edu/postings/search</a> About Athens State University Located in historic Athens, Alabama, Athens State University offers junior and senior-level coursework to community college graduates and transfer students holding sufficient credits from other institutions. Presently, over 3,100 students have selected Athens State because of its neighborly environment where 50 majors and degree programs are offered, with courses taught by a supportive and exceptional faculty. Approximately 80% of the students are enrolled in at least one online course. The typical student is a working adult who commutes. Recently, the University was featured in the 2015 Best Value Online College Rankings by OnlineU.org for four online programs including computer science, accounting, education and human resources. The University offers undergraduate degree programs in Liberal Arts, Teacher Preparation, and Business. The University employs more than 350 full and part-time employees with approximately 90 full-time faculty members in three colleges: College of Arts and Sciences, College of Business, and College of Education. Seventy-five percent of the full-time faculty members hold a terminal degree. The University is accredited by the Southern Association of Colleges and Schools Commission on Colleges. Athens, Alabama is located in north Alabama equidistant between Nashville, TN and Birmingham, AL. Athens is home to several events and festivals that have been featured as the Southeast Tourism Society’s “Top 20 Events in the Southeast” including the Athens Storytelling Festival and the Tennessee Valley Old Time Fiddlers Convention. In accordance with Athens State University Policy and guidelines, the applicant chosen for employment will be required to sign a consent form for a criminal background check. Employment will be contingent upon the receipt of a clearance notification from that criminal background check. Non-Discrimination Policy Statement Athens State University, as an equal opportunity/affirmative action institution, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. Athens State University does not discriminate on the basis of race, color, national origin, age, marital status, gender, gender identity, gender expression, pregnancy, sexual orientation, disability, religion, genetic information, or veteran status in employment, or admissions to or participation in educational programs and activities. Inquiries or concerns may be addressed to the Office of the Vice President of Enrollment and Student Support Services, 300 N. Beaty St., Athens, AL 35611, 256- 233-8175. Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-acd743e4cef27a40812f35e32df15cc2

College of Arts and Sciences Support Services Coordinator

Member Liaison Specialist (Customer Service) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Member Liaison Specialist (Customer Service) and help shape the future of healthcare where you'll be an integral part of our CS - Member Liaison team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will provide member service to seniors, persons with disabilities or chronic conditions, persons without housing and persons under the age of twenty-one (21) who participate in the Whole-Child Model program. You will serve as a liaison between members, health networks, providers and community-based organizations to facilitate access to services and help resolve health care and psychosocial issues. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>85% - Member Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assesses members' concerns to identify psychosocial or health care issues and facilitate an appropriate resolution.</li>
<li>Intakes information from members, both over the phone and/or in person, to complete requests for assistance cases, grievances and appeals, per departmental guidelines.</li>
<li>Coordinates members' health care and social service needs within and outside the health network and CalOptima Health during the original interaction.</li>
<li>Addresses member and provider inquiries, questions and concerns in all areas, including enrollment, claims, benefit interpretation, coordination of care and referrals/authorizations for medical care related to services covered under the Whole-Child Model program.</li>
<li>Guides members in understanding and accessing the benefits under the Whole-Child Model program.</li>
<li>Maintains documentation of member cases within the FACETS system.</li>
<li>Initiates referrals to internal and external care management departments and government agencies.</li>
<li>Communicates with community-based organizations, health networks, providers and vendors on behalf of members to resolve disputes, helps coordinate access to care and investigates issues preventing members from receiving medical benefits and services. </li>
</ul>
</li>
<li>10% - Administrative Support
<ul>
<li>Collaborates with interdepartmental staff in call resolution as needed.</li>
<li>Identifies calls needing case management or escalation to a supervisor, manager or director and routes them according to established guidelines.</li>
<li>Meets all regulatory key performance indicators, first call resolution requirements and business objectives of CalOptima Health. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High school diploma or equivalent PLUS 2 years of experience as a call center agent or customer/member services representative in health care required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>2 years of experience working with the needs of persons with disabilities and chronic medical conditions in a customer/member service capacity. </li>
<li>Health maintenance organization (HMO), Medi-Cal/Medicaid and health services experience. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 302 - $49,754 - $69,655 ($23.92 - $33.4880). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687129&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 11, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687129" target="_blank">https://jobs.caloptima.org/jobs/member-liaison-specialist-customer-service-505-city-parkway-west-california-united-states-c3fb6d6c-517c-418f-8d64-895099286932</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-de8018e655f9b64388465261ce5f3fed

Member Liaison Specialist (Customer Service)

Clinical Registered Nurse (RN (PACE)) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Clinic Registered Nurse (RN (PACE)) and help shape the future of healthcare where you'll be an integral part of our PACE- Clinic team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will provide high-quality, participant-centered care in a dynamic, interdisciplinary Program for All-Inclusive Care for the Elderly (PACE) environment. Also, you will support direct care and case management functions, ensuring safe, timely and effective care delivery. Lastly, you will coordinate care across clinic, home and facility-based care settings. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Clinical Practice and Care Delivery
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Conducts comprehensive assessments, triage and skilled nursing tasks, including wound care, IV insertion/removal and medication administration.</li>
<li>Develops and implements individualized care plans in collaboration with the interdisciplinary team and participant/family. </li>
<li>Provides education to participants and caregivers and responds to urgent/emergent clinical needs.</li>
<li>Performs case management duties, including facility visits, discharge planning and placement coordination.</li>
<li>Participates in initial and periodic assessments (at least every 6 months) and communicates changes in participant condition to the team.</li>
<li>Ensures accurate and timely documentation in the electronic health record (EHR). Care Coordination and Vendor Collaboration</li>
<li>Coordinates services with Home Health, Palliative and Hospice vendors to ensure seamless transitions of care.</li>
<li>Facilitates referrals and authorizations and follow-ups in accordance with organizational protocols. Team Support and Flexibility </li>
<li>Provides coverage for other RNs and adjusts staffing demands based on participant acuity.</li>
<li>Participates in interdisciplinary team meetings, case conferences and quality improvement initiatives. Leadership and Compliance</li>
<li>Oversees and mentors Licensed Vocational Nurses (LVNs) and Medical Assistants (MAs); provides clinical training and guidance.</li>
<li>Participates in clinic operations, including triage protocol development, supply tracking and safety compliance.</li>
<li>Supports program development, including input on medical equipment, EHR improvements and regulatory readiness. </li>
<li>Demonstrates accountability in quality, safety and cost-effective care delivery. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Associate degree in nursing (ADN) or related field PLUS 3 years of clinical Registered Nursing experience working with the frail or elderly population required with relevant experience within the last 3 years; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>CPR or Basic Life Support (BLS) certification required or must be obtained within six (6) months of date of hire. </li>
<li>Have access to means of transportation for work away from the primary office approximately 10% of the time required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Bachelor of Science in Nursing (BSN). </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current, unrestricted Registered Nurse (RN) license to practice in the state of California.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment more than 50 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687121&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 12, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687121" target="_blank">https://jobs.caloptima.org/jobs/clinical-registered-nurse-rn-pace-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-a8ec5122f613b84b9d53d215eccf04f7

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