field_job_employment_type

field_job_occupational_field_parents_all

field_job_experience

job_organization_name

city

state

Intern (Training and Education) CalOptima CalOptima Health is seeking a highly motivated Intern (Training and Education) to join our team. The overall purpose and objective of the Intern (Training and Education) is to gain work experience in the field prior to graduating. This is an opportunity to utilize and apply the skills and knowledge learned in the classroom setting and apply it in the workforce. The incumbent will be primarily responsible for handling department assigned projects, given a moderate degree of independence. The incumbent will frequently meet with supervisors to go over the status and progress of assignments. Under the general supervision of the Human Resources (HR) Manager of Training and Education, the incumbent will assist with administrative tasks, training coordination and logistics. The incumbent will attend and observe internal meetings and support with the design, delivery, engagement and/or evaluation of in-house learning initiatives. The incumbent will support the day-to-day tasks and requests coming to the HR Training and Education team. The incumbent will also gather statistics that will feed analytics reports. Additionally, the incumbent will complete one to three priority projects, including a Capstone project. Position Information: 
<ul>
<li>Department: Human Resources </li>
<li>Salary Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500) </li>
<li>Work Arrangement: Full Office </li>
</ul>
<ul>
<li> The submission of ALL items are required for consideration for Fall 2025: 
<ul>
<li>Completion of application </li>
<li>Resume</li>
<li>A statement of interest on why you are interested in this internship position (2 pages maximum). </li>
<li>Two (2) letters of recommendation (one academic, one professional) will be required upon confirmation of minimum qualifications.</li>
</ul>
</li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>95% - Department 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>Assists with department assigned projects.</li>
<li>Meets deadlines and completes sub-tasks of assigned projects.</li>
<li>Participates in meetings with the supervisor to go over status and progress of work. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS enrollment in a college or university two- or four-year degree program, an accredited vocational institution or a graduate program required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>N/A</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6382336&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 27, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6382336" target="_blank">https://jobs.caloptima.org/jobs/intern-training-and-education-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-da262c9e0046ce458c529d51ae362e1b

Intern (Training and Education)

Program Assistant (Quality Initiatives) CalOptima CalOptima Health is seeking a highly motivated Program Assistant (Quality Initiatives) to join our team. The Program Assistant (Quality Initiatives) will be responsible for providing administrative support for projects and department leadership. The incumbent will coordinate department meetings, take minutes and coordinate internal and external communication. The incumbent will organize and prepare materials for committee meetings, such as the Stars Steering Committee and several monthly meetings with external delegates. The incumbent will also interact with other departments and external stakeholders. Additionally, the incumbent will coordinate work and processes with other administrative staff within CalOptima Health. Position Information: 
<ul>
<li>Department: Quality Analytics </li>
<li>Salary Grade: 302 - $49,754 - $69,655 ($23.92 - $33.4880) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>95% - Administrative 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>Provides support to staff, including preparing meeting materials, maintaining minutes, routing documents, conducting data entry and handling incoming and outgoing correspondence per administrative policy.</li>
<li>Provides administrative support for specific and/or ongoing department projects, such as generating reports, logs, calendars and mailings, applying general business practices and CalOptima Health policies and procedures.</li>
<li>Serves as a liaison between directors and departmental staff and follows up on the progress of projects and activities assigned to the director's subordinates or other staff.</li>
<li>Assists with department expenses and budgeting, including processing requisitions for payment.</li>
<li>Coordinates approved travel arrangements in accordance with CalOptima Health's travel policy for the department.</li>
<li>Handles all incoming invoices and expense reports for the director and other management staff as appropriate.</li>
<li>Coordinates work with other administrative staff and supports the coordination of staff efforts within the department.</li>
<li>Coordinates the calendar and schedule of the department director, including scheduling appointments, meetings and events. Exercises discretion in committing time, evaluating needs and making meeting arrangements.</li>
<li>Determines priority of matters of attention for the director, redirects matters to staff or handles matters personally, as appropriate.</li>
<li>Maintains confidential and sensitive information and files regarding management projects, policy and personnel, ensuring appropriate follow-up.</li>
<li>Maintains department directory, organization chart, SharePoint and paid time off calendar.</li>
<li>Collects data, identifies pertinent information and assists with preparing reports and presentations. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 1 year of experience in a previous administrative support role 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>
 Preferred Qualifications: 
<ul>
<li>Associate's degree in health care management, health care administration or related field.</li>
<li>Health care experience. </li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6389183&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 29, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6389183" target="_blank">https://jobs.caloptima.org/jobs/program-assistant-quality-initiatives-505-city-parkway-west-california-united-states-cf6d60d2-6fa3-4e1d-80e4-d225a6767774</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-e4d8215d876aec40a984848fa2eaa0e3

Program Assistant (Quality Initiatives)

Head of the Implementation Science Lab in Mental Health Approval of remote and hybrid work is not guaranteed regardless of work location. For additional information on remote work at Penn State, see Notice to Out of State Applicants. POSITION SPECIFICS The Department of Psychiatry and Behavioral Health at the Penn State College of Medicine, in collaboration with the Social Science Research Institute (SSRI), invites applications for an independent, tenure-line faculty position, at the Associate Professor or Professor level. The ideal candidate will have a robust track record in developing and testing evidence-based mental health interventions in real-world clinical settings, particularly focused on reaching underserved populations. This position offers an exciting opportunity to build and lead interdisciplinary research to improve mental health outcomes by accelerating evidence-based adoption into routine care. The successful candidate will leverage SSRI's collaborative networks and resources, as well as opportunities to apply implementation science methodologies within the Department of Psychiatry and Behavioral Health's established clinical and research programs, including areas such as mood disorders, sleep medicine, autism spectrum disorders, substance use disorders, ADHD, and child/adolescent mental and behavioral health. Responsibilities: - Establish, lead, and direct the Implementation Science Lab focused on mental health - Collaborate with researchers across Penn State's colleges and interdisciplinary networks to design and test interventions targeting mental health in underserved populations - Teach and mentor graduate students, medical students, and medical trainees - Conduct and publish research on the effectiveness of mental health interventions in diverse, real-world settings - Secure external funding to support research initiatives and contribute to the department's research goals Qualifications: - PhD, MD, or equivalent in a relevant field (e.g., psychology, psychiatry, public health, social science) - Established record of research in mental health disparities, particularly in implementation science or health equity - Proven ability to lead interdisciplinary teams and collaborate with clinical and academic departments, including through SSRI-supported initiatives - Experience securing external research funding - Commitment to teaching and mentoring in a collaborative, diverse academic environment Preferred Qualifications: - Experience working with rural, underserved, or other marginalized populations - Clinical background with demonstrated interest in integrating research and clinical care, with no more than 25% clinical time required for those with a clinical degree About Penn State and Hershey: Pennsylvania State University ranks as one of the top 30 research universitites in the world, and its College of Medicine is one of the nation's leading medical schools. Located in Hershey, Penn State's College of Medicine and Penn State Health offer a dynamic, interdisciplinary environment for collaboration in mental health research. Our department is committed to research that translates into real-world improvements in health outcomes for underserved populations. Furthermore, the College of Medicine boasts a rich and growing community focused on Implementation Science, centered around the Penn State Clinical and Translational Science Institute's (CTSI) Implementation Science Core (ISC). The ISC provides infrastructure, including expert consultation, training opportunities, and pilot funding, fostering a vibrant ecosystem dedicated to bridging the gap between evidence-based practices and real-world applications to improve health equity. Penn State's interdisciplinary Social Science Research Institute (SSRI), a university-wide institute under the Office of the Senior Vice President for Research, is co-funding this position. The SSRI's mission is to foster novel and interdisciplinary research collaborations across colleges to address critical human and social problems and to disseminate and translate this work into the broader community. SSRI provides research support and consultation, funding, infrastructure support, and services to social and behavioral scientists across different colleges. Candidates whose research shows evidence of, or potential for, interdisciplinary collaborations across disciplinary lines are particularly desired. A description of the Social Science Research Institute's Strategic Foci can be found at <a href="https://apptrkr.com/get_redirect.php?id=6338065&amp;targetURL=https://ssri.psu.edu/about/ssri-overview" target="_blank">https://ssri.psu.edu/about/ssri-overview</a>. How to apply: Interested candidates should submit a CV, a cover letter outlining research interests and experience, and the names of three references. Review of applications will begin immediately and continue until the position is filled. BACKGROUND CHECKS/CLEARANCES This position requires the following clearances in addition to applicable background checks: PA State Police Criminal Background Check, PA Child Abuse History Clearance Form, and Federal (FBI) Fingerprint Criminal Background Check. BENEFITS Penn State provides a competitive benefits package for full-time employees designed to support both personal and professional wellbeing. In addition to comprehensive medical, dental, and vision coverage, employees enjoy robust retirement plans. One of the standout benefits is the generous 75% tuition discount, available to employees as well as eligible spouses and children. For more detailed information, please visit our <a href="https://apptrkr.com/get_redirect.php?id=6338065&amp;targetURL=https://hr.psu.edu/current-employee/benefits" target="_blank">Benefits Page.</a> EEO IS THE LAW Penn State is an equal opportunity employer and is committed to providing employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. If you are unable to use our online application process due to an impairment or disability, please contact 814-865-1473. The Pennsylvania State University is committed to and accountable for advancing equity, respect, and belonging in all its forms. We embrace individual uniqueness, as well as a culture of belonging that supports both broad and specific equity initiatives, leverages the educational and institutional benefits of inclusion in society, and provides opportunities for engagement intended to help all members of the community thrive. We value belonging as a core strength and an essential element of the university's teaching, research, and service mission. Apply online at <a href="https://apptrkr.com/6338065" target="_blank">https://psu.wd1.myworkdayjobs.com/PSU_Staff/job/College-of-Medicine/Head-of-the-Implementation-Science-Lab-in-Mental-Health_REQ_0000067767-1</a> CAMPUS SECURITY CRIME STATISTICS: For more about safety at Penn State, and to review the Annual Security Report which contains information about crime statistics and other safety and security matters, please go to <a href="http://www.police.psu.edu/clery/" target="_blank">http://www.police.psu.edu/clery/</a>, which will also provide you with detail on how to request a hard copy of the Annual Security Report. Penn State is an equal opportunity, affirmative action employer, and is committed to providing employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. 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-b1487b18ac7e2c4ab551272b19775b5a

Head of the Implementation Science Lab in Mental Health

Risk Adjustment Analyst - Remote REQ-2025-170 Portland, ME Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Risk Adjustment Analyst provides analytic, technical, and decision support to the Risk Adjustment Team utilizing third party software as well as the data warehouse as key sources of data. The Analyst works closely with our internal customers related to their department-specific action plans by providing accurate, timely, and consistent information enabling informed decisions related to risk adjustment activities. The Analyst provides subject matter expertise based on content knowledge and analytical capabilities to guide and educate customers on risk adjustment from a range of operational lenses and levels of analysis. This individual also participates in team projects and special analytical assignments in their area of expertise. Job Description Key Outcomes: 
<ul>
<li>Conducts analyses to inform business decisions and activities related to risk adjustment</li>
<li>Develops monitoring and tracking reports and dashboards and conducts analyses to inform business decisions and activities related to risk adjustment</li>
<li>Provides analytic mentorship and guidance to operational departments related to risk adjustment</li>
<li>Liaison with key supporting departments, IT and Informatics, on risk &amp; revenue optimization</li>
<li>Tracks progress and activities within their assigned key initiatives</li>
<li>Provides standardized reports and processes for analyzing data from multiple sources</li>
<li>Works directly with vendors to coordinate needs, resolves issues, and implements data transmission processes</li>
<li>Participates in vendor research, software installation, configuration support, and interface development applications as needed</li>
<li>Supports CMS HCC Risk Adjustment modeling</li>
<li>Maintains and is a proficient user of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding</li>
<li>Recommends tools and methodologies that can be deployed at the organizational level, to the departments, and with external partners</li>
</ul>
 Education/Experience: 
<ul>
<li>Bachelor's degree or equivalent experience required</li>
<li>Minimum of 3 years' experience related to reporting and analysis of health care data ideally in the areas of managed care, health care delivery, code sets, and/or reimbursement</li>
<li>Experience in developing cost-benefit and ROI analyses</li>
</ul>
 Skills/Knowledge/Competencies (Behaviors): 
<ul>
<li>Strong interpersonal and communication skills, both verbal &amp; written</li>
<li>Solid skills in providing analytic results using a variety of quantitative, qualitative, and visualization mediums</li>
<li>Strong analytical abilities with attention to detail</li>
<li>Ability to manage multiple priorities and deadlines</li>
<li>Familiarity with healthcare applications and business management software applications</li>
<li>Proven ability to pull data from multiple sources and provide complex analyses presented to a wide range of audiences</li>
<li>Proven strength in data management practices</li>
<li>Demonstrated knowledge of Microsoft Office products, especially Transact-SQL and data visualization tools (Cognos,Tableau)</li>
<li>Capable of determining when issues need escalation or prioritization with self-starter reliability and follow-through</li>
<li>Capable of utilizing a variety of analytical techniques to solve problems.</li>
</ul>
 This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Do you have a question about careers at Martin's Point Health Care? Contact us at: <a href="https://apptrkr.com/get_redirect.php?id=6379345&amp;targetURL=mailto:jobinquiries@martinspoint.org" target="_blank">jobinquiries@martinspoint.org</a> To apply, visit <a href="https://apptrkr.com/6379345" target="_blank">https://martin.wd1.myworkdayjobs.com/en-US/MPHC/job/Portland-ME/Risk-Adjustment-Analyst_REQ-2025-170</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> $GUIDad-logos/L5013353.gif

Risk Adjustment Analyst - Remote

Customer Service Rep (CCSC) (Bilingual Required) CalOptima CalOptima Health is seeking a highly motivated Customer Service Rep (CCSC) (Bilingual Required) to join our team. The Customer Service Representative will be the representative at the Orange County Community Service Center (CCSC) location for CalOptima Health's members and Orange County residents. The incumbent will address and document member inquiries and complaints fairly and effectively. The incumbent will provide information regarding eligibility, enrollment, benefits and services available to CalOptima Health's eligible members and refer individuals to other CCSC personnel as necessary. Position Information: 
<ul>
<li>Department: Customer Service </li>
<li>Salary Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500) </li>
<li>Work Arrangement: Full Office </li>
</ul>
 Duties &amp; Responsibilities: 
<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>Addresses member inquiries, questions and concerns in all areas, including CalOptima Health's eligibility, enrollment, billing, benefit interpretation and referrals/authorizations for medical care in-person, via email or phone.</li>
<li>Communicates, builds and maintains internal and external relationships by prompt and accurate service.</li>
<li>Identifies and communicates challenges that might arise with the use of professional judgement while adhering to departmental policies and procedures.</li>
<li>Serves as a mediator to ensure the interests of members and CalOptima Health are protected.</li>
<li>Follows through on and completes all member and provider inquiries or requests.</li>
<li>Enters accurate, complete and correct documentation regarding all issues and/or inquiries, complaints and grievances into the CalOptima Health system.</li>
<li>Engages and collaborates with CCSC staff as necessary based on the needs of CalOptima Health's members for additional benefits and/or community services.</li>
<li>Maintains departmental productivity and quality standards. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 6 months of experience in a call center capacity 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>Typing speed of 35 words per minute (WPM) required. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese) required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>6 months of Health Maintenance Organization (HMO), Medi-Cal/Medicaid and health services experience.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6385642&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 28, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6385642" target="_blank">https://jobs.caloptima.org/jobs/customer-service-rep-ccsc-bilingual-required-county-community-service-center-brea-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-50829ee0851ca744b9dde0b061944959

Customer Service Rep (CCSC) (Bilingual Required)

Board Engagement Officer |Pine Street Inn | Boston, Ma (Hybrid) About Pine Street Inn Pine Street Inn opened its doors in 1969. Over more than five decades, it has grown into New England's largest nonprofit homeless services provider. Throughout the ‘80s and ‘90s, Pine Street expanded from offering basic necessities—food, clothing, shelter, and health care—to offering programs that help guests take significant steps in their journey out of homelessness and regain some of what they have lost: relationships, life skills, employment, and housing. In the past ten years, Pine Street has significantly expanded its inventory of permanent supportive housing to provide lasting solutions to homelessness. Pine Street now owns or operates more than 1,100 units of housing, with more on the way. Pine Street's programs include: • Permanent Supportive Housing – More than 1,100 individuals live in 38 residences and housing units throughout Greater Boston. The program for tenants follows a supportive housing model – permanent housing coupled with on-site support staff to help each individual regain their highest level of independence. Specialized housing is available for seniors, adults with mental health disabilities, and veterans. Pine Street currently has a housing retention rate of 96%. • Emergency Shelter – Each night, Pine Street Inn operates four emergency shelters. Each offers a warm and safe bed, nutritious meals, and shower and locker facilities, as well as access to health care, substance use treatment and mental health support. Innovative new programs such as Triage and Rapid Rehousing are creating new paths out of Pine Street's shelters and into the stability of housing. • Job Training – Pine Street provides job training in food services and housekeeping, providing individuals with the skills they need to find and retain jobs. Approximately 150 individuals participate in job training programs each year, which culminate in an annual "graduation" ceremony celebrating their accomplishments. • Street Outreach – Pine Street's day and night street outreach teams travel throughout Greater Boston to offer food, blankets, health care, access to shelter and a pathway to housing to 75+ unsheltered individuals. Today, Pine Street Inn supports more than 2,000 individuals a day. From emergency services, to needs assessment, counseling, and case management, to job training and placement in permanent housing, Pine Street Inn is providing short-term remedies and long-term solutions to end the experience of homelessness. About Philanthropy at Pine Street Inn Pine Street's $100M annual operating budget is primarily funded through government grants and private philanthropy. In FY2025, Pine Street raised more than $35M, of which nearly $24M was in unrestricted operating support. Pine Street has a robust donor community of 25,000+ and a deep and active volunteer base. Pine Street's Advancement department is led by Chief Advancement Officer, Becky Crawford. The Board Engagement Officer will join a growing team of over 30 advancement staff across major and planned giving, institutional giving, annual giving, development services, event and volunteer engagement, and marketing and communications. About the Position Reporting directly to the Chief Advancement Officer, the Board Engagement Officer will enrich, manage, and implement a robust Board engagement program that encompasses the recruitment and nomination processes, new member onboarding, Governance committee work, and overall engagement and stewardship of all prospective, current, and past members. In doing so, they will aim to enhance Board member experience and deepen their connection to Pine Street, while also ensuring that Pine Street fully leverages the expertise and connections of each member. A highly collaborative role, the Officer will directly interface with and support Board members. The Officer will be an essential convener of all internal partners - in Advancement, the President's Office, and Pine Street's executive leadership team - to create a strategic, comprehensive, and streamlined program. Key Responsibilities Board Engagement: • Enrich a Board engagement program - including social, educational, and service opportunities - to enhance Board member experience and satisfaction • Work closely with the Volunteers team to develop regular engagement opportunities highlighting different aspects of Pine Street's work • Create and maintain consistent Board onboarding process with enhanced materials and programing, and implement with the support of the President's Office • Develop and manage a Board mentorship program with defined structure and guidelines, thoughtful assignments, and regular support • Plan and manage logistics of annual Board reception • Develop a system to report on member participation, engagement, and impact Committee Management: • Maintain and apply excellent working knowledge of Pine Street Inn bylaws • Establish annual goals for the Governance Committee in accordance with the bylaws • Manage and update Governance Committee calendar • Understand and track current assets and gaps on the Board and work closely with President, CAO, and Governance Chair in determining Board composition goals • Plan and support Governance Committee Meetings, including agenda and presentation preparation, communications, logistics, and follow-up • Support Governance Committee Chair and committee members in their work • Manage Board renewal process • Oversee and codify Board recruitment process including identification, recruitment, nomination, and confirmation • Ensure all Board candidates are cultivated and stewarded by colleagues in Advancement and/or other institutional leaders, and recognize outgoing members • Document pathways for joining the Board suitable for sharing with Board Chair, Governance Committee members, and candidates • Develop and/or revise job descriptions for all members, officers, and committee chairs Board Advancement Initiatives: • Coordinate Board solicitations with CAO and Senior Director of Major and Planned Gifts • With CAO and Senior Director of Major and Planned Giving Help Establish a Board Advancement Committee, setting clear objectives and measurable outcomes. • Plan and support Advancement Committee Meetings, including agenda and presentation preparation, communications, logistics, and follow-up • Support Advancement Committee Chair and members in their work • Track activity and follow up, reporting on member participation, engagement, and impact Board Administration and Support: • Support CAO in Board meeting preparation, including development of the Advancement and Governance Committee Board Reports • Prepare materials and presentations for Board orientation • Comprehensively track Board participation, terms, and committee assignments • Update and maintain prospective board member data and follow up • Work closely with all relevant internal partners, including the CAO, Senior Leadership Team, the Advancement Office, the President's Office, and others • Attend Advancement and Major and Planned Giving team meetings Key Qualifications: The successful candidate will be a strategic, creative and detail-oriented development professional who can advance Pine Street's vision for philanthropy. The Board Engagement Officer will have an appreciation for diverse perspectives and will possess outstanding interpersonal competencies, the ability to effectively engage donors and volunteers, and a deep commitment to instilling best practices that reflect Pine Street's values. • 5-7 years of progressively responsible experience in a successful individual giving program or a relevant field • Experience with managing and engaging Board level volunteers, including volunteer committees • Strong verbal and written communication skills, presentation skills, and analytical skills • Commitment to the mission of Pine Street Inn • Self-motivated and entrepreneurial approach to work • Strong commitment to working in a collaborative environment • A metrics-driven mindset that informs strategy • Exceptional attention to detail • Thorough, organized, strategic, and creative approach to volunteer management • Flexibility, tenacity, sense of humor, a team player •Proficiency in Raiser's Edge and Microsoft Office • A bachelor's degree or equivalent experience • Some weekend, evening, and holidays required All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, veteran status, or any other characteristic protected by law. All Pine Street Inn employees must comply with Pine Street Inn's occupational health policy. The starting annual salary for this role is $115,000. Final offers for this position will be based upon several factors including the position requirements, candidate's experience level and capabilities. This position is eligible for a hybrid work schedule, which includes regular on-site work and local travel. Please submit your cover letter and resume in confidence <a href="https://apptrkr.com/get_redirect.php?id=6390576&amp;targetURL=https://www.developmentguild.com/current-searches/board-engagement-officer-pine-street-inn/" target="_blank">here.</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-9f0ae232ca88af45aaecc573cb79d387

Board Engagement Officer

Program Specialist, Sr. (Community Relations) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Specialist Sr to join our team. The Program Specialist Sr for Community Relations will assist in the development, planning and execution of community relations strategies, communications and activities. The incumbent will work closely with the department director to support community engagement with key stakeholders, program development, implementation of special projects, large scale events and meetings with key stakeholders to support CalOptima Health initiatives. The incumbent is responsible for overseeing and leading leaderships' participation and administrative support for special events, projects and meetings led by CalOptima Health and our key community stakeholders. The incumbent will serve as a subject matter expert to team members with their outreach and education activities. The incumbent will interface and work collaboratively with internal staff, members and community stakeholders, and support other key CalOptima Health leaders and staff on related projects. The incumbent will update and support internal staff members and requests from internal departments and external stakeholders for meetings and presentations and will participate in community events. Integrity and the ability to maintain confidentiality are essential. Position Information: 
<ul>
<li>Department: Community Relations </li>
<li>Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>75% - 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>Facilitates the coordination of communication materials for CalOptima Health's leadership, including but not limited to, talking points, presentations and correspondence and to educate government and community officials regarding CalOptima Health's mission, strategic priorities, policy positions, projects, plans and other activities.</li>
<li>Participates and provides direct support with CalOptima Health's initiatives, large-scale events and other high-profile projects.</li>
<li>Serves as the subject matter expert to support team members with their outreach and education activities.</li>
<li>Serves as a liaison between Community Relations and various internal departments to coordinate their participation and support with internal and external events and meetings.</li>
<li>Tracks, monitors and provides updates for specific and/or ongoing projects, such as generating reports, logs, calendars, and mailings, developing and managing databases, and applying general business practices, as well as CalOptima Health policies and procedures.</li>
<li>Maintains confidential and sensitive information and files regarding management projects and policy.</li>
<li>Directs and assigns projects and/or tasks to appropriate staff, as needed. </li>
</ul>
</li>
<li>20% - Administrative Support
<ul>
<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>Oversees and coordinates email and telephone requests from leaders, internal departments and external stakeholders.</li>
<li>Oversees the department's database and inventory for outreach and education materials and supplies. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in political science, public policy, public administration, communications, health care administration or related field PLUS 3 years of work experience in community or public relations and/or project management required or 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, or other approved means of transportation, an acceptable driving record, and current auto insurance will be required for work away from the primary office 10% of the time.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Experience working in community health, public affairs, communications, public health or related field</li>
<li>Strategic planning and project management experience. </li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>n/a</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6374350&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 23, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6374350" target="_blank">https://jobs.caloptima.org/jobs/program-specialist-sr-community-relations-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-643fc59b0146d245accf54a2ee8ed7c0

Program Specialist, Sr. (Community Relations)

Sr Manager, Operation and Business Configuration (Sr Manager I) CalOptima CalOptima Health is seeking a highly motivated Sr Manager, Operation and Business Configuration (Sr Manager I) to join our team. The Sr Manager I for Operation and Business Configuration will function as a primary point of contact for the claims analytical support unit which consists of data analytics, process improvement and claims clearinghouse vendor oversight. The incumbent will collaborate with leadership on the development and implementation of analytical tools to identify department trends and will manage dedicated resources for the day-to-day operations to carry out the strategic and tactical execution of CalOptima Health business operations, ensuring compliance with business rules and government regulations. Position Information: 
<ul>
<li>Department: Claims Administration </li>
<li>Salary Grade: 316 - $120,881 - $193,410 ($58.12 - $92.9856) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>40% - Leadership Functions
<ul>
<li>Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.</li>
<li>Hires, manages, trains, reviews and sets goals for the department and staff.</li>
<li>Provides an environment that engages staff to fully participate in the overall department functions and workload balancing strategies.</li>
<li>Develops and implements corrective action plans and trains staff as needed.</li>
<li>Establishes and manages teams to a set of standards and governance to improve performance and support effective development and outputs.</li>
<li>Provides management oversight and direction to Data Analysts Business team and serves as a liaison with internal and external entities such as Clearinghouse and health networks to ensure claims and authorization data load integrity.</li>
<li>Provides management oversight and direction to the Clearinghouse Data Analyst team for intake requirements, analysis, conducting clearinghouse user acceptance testing and identifies impacts to systems and processes.</li>
<li>Tracks and trends teams performances by way of dashboards, monitoring day-to-day activities of each claim operational areas, claims operational vendors and all clearinghouses.</li>
<li>Represents Claims department and participates in regulatory audit presentations and demonstrations and conducts follow up remediation action items from the audit as needed.</li>
<li>Works collaboratively with the Office of Compliance, Information Technology (IT), claims vendors and internal business teams on regulatory changes impacting claims adjudication and data integrity.</li>
<li>Manages all claims vendor contract or scope of work (SOW) renewals and takes the lead for any request for proposal projects.</li>
<li>Participates in CalOptima Health's enterprise projects impacting claims or operational payments and procedures/policies.</li>
<li>Conducts claims presentation to staff, senior level leadership and CalOptima Health network providers.</li>
<li>Maintains quality goals and production level within the department by collaborating with Claims department leadership teams and ensures that performance goals are consistently met and/or exceeded.</li>
<li>Anticipates future demands of initiatives, strategic plans and regulatory updates and design/implement solutions to meet these needs. </li>
</ul>
</li>
<li>35% - Program Oversight
<ul>
<li>Ensures compliance with applicable internal policies and procedures and external state and federal regulations for multiple product lines (Medi-Cal, Medicare, Commercial (Covered California) and Program of All-Inclusive Care for the Elderly (PACE). Ensures overall claims adjudication is in accordance with the California Department of Managed Health Care (DMHC), California Department of Health Care Services (DHCS) and Centers for Medicare &amp; Medicaid Services (CMS) health plan regulatory requirements and guidelines.</li>
<li>Intakes and reviews All Plan Letters (APL), CMS bulletins and regulatory guidance; oversees the development, timely and accurate implementation and publication/posting of claims-related regulatory requirements and reporting.</li>
<li>Serves as the primary point of contact to answer questions related to system configuration business rules, various claim adjudication issues and resolves complex claims or benefit adjudication issues for department staff as well as other internal customers; responsible for the identification and resolution of provider claim issues including support of provider education and customer service staff in communications back to providers.</li>
<li>Reviews and maintains department policies and procedures, recommends changes for more efficient operations, drafts new policies and procedures for director's review, communicates changes and updates to staff when appropriate.</li>
<li>Stays current with regulatory guidelines impacting essential functions and data requirements. </li>
</ul>
</li>
<li>20% - Technical Operations
<ul>
<li>Develops the claims data standards and deploys automation tools to obtain and process claims data from different sources. Constructs datasets to analyze, inform, identify trends and support stakeholder decision-making.</li>
<li>Identifies claims transaction inconsistencies, as well as implementation of controls and changes to systems and policies that support claims adjudication, thereby minimizing incorrect claims payment.</li>
<li>Manages activities/service requests with Facets configuration, IT and EDI teams to scope, prioritize, and implement requirement changes.</li>
<li>Manages and intakes all program implementation impacting Facets and systems supporting the Claims, Grievance and Appeals Resolution Services (GARS)/Provider Dispute Resolution (PDR) and Customer Service operations. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in health information management, business administration, health administration or related field PLUS 5 years of experience in information technology business experience implementing claims adjudication programs and projects in a health plan 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>5 years of management/leadership experience that manages claims operation from intake to output of the claims payment required. </li>
<li>5 years of experience utilizing Microsoft technologies required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>N/A</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6372553&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 22, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6372553" target="_blank">https://jobs.caloptima.org/jobs/sr-manager-operation-and-business-configuration-sr-manager-i-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-f254b5d52e384f44aad2de542f28a181

Sr Manager, Operation and Business Configuration (Sr Manager I)

Customer Service Coordinator (Medi-Cal Customer Service) CalOptima CalOptima Health is seeking a highly motivated Customer Service Coordinator (Medi-Cal Customer Service) to join our team. The Customer Service Coordinator (Medi-Cal Customer Service) will be responsible for providing quality service to members, conducting member-focused research and assisting with other call center activities. The incumbent will coordinate members' health care needs by engaging with health networks, providers and other CalOptima Health departments. The incumbent will remain current on the latest information about CalOptima Health's member benefits, policies and procedures in order to provide accurate information/case resolutions to members. Position Information: 
<ul>
<li>Department: CS - Medi-Cal Call Center </li>
<li>Salary Grade: 303 - $51,744 - $72,441 ($24.88 - $34.8274) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
<ul>
<li>Duties &amp; Responsibilities:</li>
</ul>
<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>Coordinates and handles case load, researches and ensures cases are resolved within departmental and regulatory standards.</li>
<li>Maintains documentation of member cases in CalOptima Health's system.</li>
<li>Provides assistance and education to members regarding benefits, health coverage and continuity of care issues.</li>
<li>Initiates referrals to both internal and external care management departments and other government or outside agencies.</li>
<li>Assesses members' concerns to identify health care issues and facilitates an appropriate resolution.</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>
<li>Identifies cases needing case management or escalation to a supervisor, manager, or director and routes according to established guidelines.</li>
<li>Provides input towards developing, maintaining and updating training documents and desktop procedures as needed.</li>
<li>Handles escalated member and provider calls as needed. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 2 years of experience as a call center agent or customer/member service in a health care setting or managed care plan 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>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese) required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Associate's degree in health care administration or related field.</li>
<li>1 year of experience handling health care coordination/casework in a customer/member service capacity.</li>
<li>Experience in Health Maintenance Organization (HMO), Medi-Cal/Medicaid and Health Services.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6374315&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 23, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6374315" target="_blank">https://jobs.caloptima.org/jobs/customer-service-coordinator-medi-cal-customer-service-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-8512a2f9aba4ba44a98c4aa03571e9ea

Customer Service Coordinator (Medi-Cal Customer Service)

Therapy Aide (Recreational) CalOptima CalOptima Health is seeking a highly motivated Therapy Aide (Recreational) to join our team. Under the direct supervision of the Supervisor Day Center (PACE) and working under the guidance of the Activity Coordinator, the Therapy Aide (Recreational) will provide therapeutic and recreational support services to CalOptima Health's Program for All-Inclusive Care for the Elderly (PACE) participants in the day health center. Additionally, the incumbent will perform other activities and tasks as assigned. Position Information: 
<ul>
<li>Department: PACE- Clinic </li>
<li>Salary Grade: 304 - $53,813 - $80,720 ($25.87 - $38.8077) </li>
<li>Work Arrangement: Full Office **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<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>Assists in the coordination of the day center's social programming and activities, communicates current events and PACE organizational issues to participants in a culturally and linguistically appropriate manner.</li>
<li>Facilitates recreational programming in accordance with individual treatment plans and participates in social and recreational activities with participants.</li>
<li>Supports with coordinating and facilitating participant outings, special events and activity ideas and collaborates with other departments.</li>
<li>Supports supervision of the participant's level of engagement and involvement and provides feedback to the Activity Coordinator; documents activity services provided (e.g., charge tickets). </li>
<li>Reports observed changes in the participant's conditions to the supervisor and other Interdisciplinary Team (IDT) members as appropriate. </li>
<li>Maintains and ensures activity supplies are consistently available for participant use.</li>
<li>Demonstrates safe practices with participants utilizing proper body mechanics as needed and complies with universal precautions.</li>
<li>Assists with care plan assessments as needed. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 1 year of experience with the frail or elderly population within the last 3 years required, preferably in a social or recreational program setting; 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>1 year of experience with people with dementia required.</li>
<li>CPR and First-Aid Certification required or must be obtained within six (6) months of the date of hire.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Bachelor's degree in recreational therapy or related field.</li>
<li>Experience in event planning or activity coordination.</li>
<li>Experience designing engaging activities for diverse groups with different interests and abilities</li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6374968&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 23, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6374968" target="_blank">https://jobs.caloptima.org/jobs/therapy-aide-recreational-pace-garden-grove-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-1fbc4d516e4c304185ac2788c30c1b4c

6,986 health-educator Jobs