‍Position Overview: We are seeking a motivated and compassionate IT Project Manager to lead and manage our dynamic team dedicated to making a positive impact on our community. As the IT Project Manager, you will play a pivotal role in coordinating outreach initiatives, overseeing day-to-day operations, and ensuring the delivery of exceptional services to our target demographic.

Responsibilities:

• As an important partner of business lines, have an in-depth understanding of the strategic planning and goals of the business side, and formulate corresponding IT strategic plan to align with business goals.
• Establish close cooperation and trust relationships with leaders of various business lines, continuously promote IT visibility and influence from the business side and improve overall customer satisfaction
• Closely cooperate and organize IT Services Owners, deliver high quality IT services to meet and lead the industry's service level, and build solutions for key business needs and enable business fast growth.
• Explore and combine industry trends and best practices, to proactively provide constructive suggestions and solutions for business requirements.
• Responsible for the management of important business projects and programs, including organizing various project meetings, monitoring the project execution process, discovering and resolving major risk points, and controlling changes in requirements
• Cross functions information communication and resource coordination, efficiently promote the alignment and implementation of technical solutions, business guidelines and process systems, and ensure the achievement of project and business goals.

Additional responsibilities include:

• Advocate as a champion of change for our customers' strategic plans.
• Identify and implement opportunities for service improvement, cost optimization, and increased efficiency.
• Develop tools and solutions to increase the operational efficiency of the IT process with a focus on excellent user experience.
• Occasional travel is required.

Qualifications:

• Bachelor's Degree in Computer Science, Systems Science, or Computer Engineering.
• A minimum of 5 years working in the Healthcare IT field with a focus on championing organizational evolution, e.g., leading initiatives, products, services, or interactions, business support experience is preferred.
• Strong knowledge of IT infrastructure (Network, VPN, firewall, virtualization, servers, storage, etc.).
• Strong communication and collaboration skills, build and maintain strong relationships with partners at all levels of the organization, and able to call high among core leadership team level in business line.
• Strong motivation and influence skills to build common ground between IT and business, communicate effectively with various technical or non-technical personnel, and align the best solutions and implement them through informal leadership ability.
• Strong business learning and analysis ability, sense of responsibility, logical thinking, curiosity and self-learning ability for new technologies.
• Strong stress resistance, able to adapt to multi-tasking, demanding, flexible and professional work environment.
• Systematic problem-solving approach with the ability to adjust quickly to changing priorities and progress in high ambiguity and uncertainty areas.

Job Type: Full-time

Pay: $95,000.00 - $110,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance

Experience level:

• 5 years

Schedule:

• 8 hour shift

Experience:

• Healthcare IT field: 5 years (Preferred)

Work Location: Remote

Link to apply: IT Project Manager - California - Indeed.com FCHN

‍Position Overview: The Senior EDI Analyst is accountable for developing best business practice knowledge and supporting the business in integrating into the EDI solutions (standards and non-standard EDI systems). The Senior EDI Analyst will also be assisting EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions which include working with external trading partners, transferring data through secure channels, loading the data to the production environment, and testing files from new providers/trading partners.

Responsibilities:

• Work with providers, clearing houses, 3 rd party vendors, and software companies to facilitate exchange of HIPAA-compliant ANSI X12 EDI transactions between PHC and its trading partners.
• Coordinate testing the electronic transactions with trading partners and other certification authorities for projects such as ICD-10 and CORE. Assist EDI team in diagnosing problems with inbound claims, providing assistance to Claims, Member Services, and Provider Relations department staff.
• Work with internal and external implementation teams and work cross-functionally between the business and IT to resolve technical issues.
• Meet with end-users inside and outside of PHC and collect the requirements for developing EDI applications.
• Develop SDLC (Software Development Life Cycle) documents such as Business Requirement Document, Process Flow, Business Case Study Document, and Test Case Document.
• Research, analyze, and evaluate technical requirements and specifications for the seamless integration of EDI solutions.
• Analyze and complete EDI requests on time and with high quality including resolving trouble tickets and providing technical solutions.
• Work with programming staff on data formatting/mapping of electronic data and transmission related tasks and issues.
• Develop and maintain the documentation for each interface including policies and procedures related to the highly complex integrated EDI interfaces.
• Assist EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions using tools such as Active Batch and Oracle TOAD.
• Gain better understanding on the HIPAA-compliant 5010 TR3 specification documents.
• Review EDI development work for compliance within the established state and federal guidelines.
• Participate in negotiation of trading partner agreement and provide assistance to providers in preparing HIPAA-compliant transactions for PHC.

Secondary Duties And Responsibilities:

• Participate in special projects and assignments as needed.

Qualifications:

• Bachelor’s degree in a related field, or equivalent combination of education and experience.
• Minimum one (1) year of EDI involvement in healthcare.
• Experience developing SDLC (Software Development Life Cycle) documents such as Business Requirement Document, Process Flow, and Business Case Study documents are added advantage.
• Comparable education and experience as an alternative.
• RDBMS experience to write simple SQL queries is required.

Special Skills, Licenses and Certifications:

• Understanding of HMO claims/billing processes
• Communicate effectively with inside staff and outside sources
• Ability to research and work with outside providers in a multitude of complex environments
• Basic SQL commands for electronic table maintenance.
• Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

Performance Based Competencies:

Excellent interpersonal, team, customer service, and communication (written and verbal) skills with ability to assess and resolve problems and issues in an efficient and effective manner; strong project management skills.

Job Type: Full-time

Pay: $100,000.00 - $110,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance

Experience level:

• 3 years

Schedule:

• 8 hour shift

Experience:

• EDI involvement in healthcare: 1 year (Required)

Work Location: Remote

Link to apply: IT Project Manager - California - Indeed.com FCHN

‍Position Overview: The EDI Analyst is accountable for developing best business practice knowledge and supporting the business in integrating into the EDI solutions (standards and non-standard EDI systems). The EDI Analyst will also be assisting EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions which include working with external trading partners, transferring data through secure channels, loading the data to the production environment, and testing files from new providers/trading partners.

Responsibilities:

• Work with providers, clearing houses, 3rd party vendors, and software companies to facilitate exchange of HIPAA-compliant ANSI X12 EDI transactions between PHC and its trading partners.
• Coordinate testing the electronic transactions with trading partners and other certification authorities for projects such as ICD-10 and CORE. Assist EDI team in diagnosing problems with inbound claims, providing assistance to Claims, Member Services, and Provider Relations department staff.
• Work with internal and external implementation teams and work cross-functionally between the business and IT to resolve technical issues.
• Meet with end-users inside and outside of PHC and collect the requirements for developing EDI applications.
• Develop SDLC (Software Development Life Cycle) documents such as Business Requirement Document, Process Flow, Business Case Study Document, and Test Case Document.
• Research, analyze, and evaluate technical requirements and specifications for the seamless integration of EDI solutions.
• Analyze and complete EDI requests on time and with high quality including resolving trouble tickets and providing technical solutions.
• Work with programming staff on data formatting/mapping of electronic data and transmission related tasks and issues.
• Develop and maintain the documentation for each interface including policies and procedures related to the highly complex integrated EDI interfaces.
• Assist EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions using tools such as Active Batch and Oracle TOAD.
• Gain better understanding on the HIPAA-compliant 5010 TR3 specification documents.
• Review EDI development work for compliance within the established state and federal guidelines.
• Participate in negotiation of trading partner agreement and provide assistance to providers in preparing HIPAA-compliant transactions for PHC.

Secondary Duties And Responsibilities:

• Participate in special projects and assignments as needed.

Qualifications:

• Bachelor’s degree in a related field, or equivalent combination of education and experience.
• Minimum one (1) year of EDI involvement in healthcare.
• Experience developing SDLC (Software Development Life Cycle) documents such as Business Requirement Document, Process Flow, and Business Case Study documents are added advantage.
• Comparable education and experience as an alternative.
• RDBMS experience to write simple SQL queries is required.

Special Skills, Licenses and Certifications:

• Understanding of HMO claims/billing processes
• Communicate effectively with inside staff and outside sources
• Ability to research and work with outside providers in a multitude of complex environments
• Basic SQL commands for electronic table maintenance.
• Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

Performance Based Competencies:

Excellent interpersonal, team, customer service, and communication (written and verbal) skills with ability to assess and resolve problems and issues in an efficient and effective manner; strong project management skills.

Job Type: Full-time

Pay: $80,000.00 - $90,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance

Experience level:

• 3 years

Schedule:

• 8 hour shift

Experience:

• EDI involvement in healthcare: 1 year (Required)

Work Location: Remote

Link to apply: Data Analyst - California - Indeed.com FCHN

‍Position Overview: The Network Outreach Coordinator facilitates referrals and client assignments for enhanced care management between Full Circle Health Network providers and Medi-Cal managed care plans. Reporting to the Full Circle Director of Network Operations, the outreach coordinator is responsible for following outreach and engagement protocols and employing motivational interviewing techniques to encourage clients to consent to participate in the enhanced care management (ECM) program. The outreach coordinator is also responsible for ensuring clients who do consent to participate are referred and connected to the provider in the Full Circle who can best address their whole-person needs, as appropriate.

DUTIES AND RESPONSIBILITIES:

• Conduct outreach and engagement activities following Full Circle protocols to facilitate linkage to the ECM program. Outreach and Engagement consists of phone calls, mailed information, and field visits.
• Serve as the day-to-day contact for managed care plans and network providers to address questions about the status of referrals or cases assigned across the Full Circle network.
• Gain a deep understanding of the Full Circle provider network to support appropriate referrals.
• Attention to detail to monitor client assignment and complete tasks in line with required timeframes established in Full Circle P&Ps.
• Ability to engage clients in multiple modalities, including text, email, telephone, and possibly in person.
• Escalate issues appropriately to the Director of Network Operations and provide input into continuous quality improvement efforts.
• Complete all documentation in the required electronic system within the timeframes established.
• Attend meetings with managed care plans and providers as assigned.
• Attend training as assigned.
• Support data entry of services as needed into health plan portals.
• Perform all other duties as assigned.
• Ensures client patient confidentiality.

KNOWLEDGE, SKILLS & ABILITIES:

• Interpersonal savvy, demonstrated by the ability to interact with and influence people to establish trust and build strong relationships.
• Experience with usage of EMR/EHRs/Care Management software
• Strong organizational skills and ability to manage and maintain a busy schedule.
• Ability to establish priorities and meet deadlines.
• Ability to work independently within a virtual operating environment and as part of a team.
• Excellent oral and written communication skills
• Ability to exercise judgment in the application of professional services.
• Active listening skills and genuine compassion for others.
• Enjoys collaboration within a team environment and working with people of different skills and experience.
• Commitment to represent the company with professionalism.
• Demonstrates cultural competency and ability to work with diverse groups of community clients.
• Comfortable using computer for documentation, communication, and organizing work.
• Working knowledge or Microsoft Excel to maintain spreadsheets for data tracking, writing basic formulas to standardize data, and create reports through pivot tables, filtering and grouping data.

MINIMUM REQUIREMENTS:

• At least 3 years of relevant work experience
• High school graduate or GED required
• Long-time resident of the community with good knowledge of the resources of this community
• Ability to complete the training program and ongoing educational requirements as assigned
• Ability to work flexible hours, including occasional night/weekend work

PREFERRED QUALIFICATIONS:

• Multilingual capabilities preferred, but not required
• Customer service: 2 years (preferred)
• Prior experience as a Community Health Worker, Peer Support Specialist, Medical Assistant or similar role a plus

PLEASE SEND COVER LETTER, RESUME AND COMPLETE ASSESSMENTS WHEN APPLYING.

Excellent interpersonal, team, customer service, and communication (written and verbal) skills with ability to assess and resolve problems and issues in an efficient and effective manner; strong project management skills.

Job Type: Full-time

Pay: $26.44 - $31.25 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Ability to commute/relocate:

• Sacramento, CA 95816: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• How many years of experience with usage of EMR/EHRs/Care Management software?

Work Location: Hybrid remote in Sacramento, CA 95816

Link to apply: Network Outreach Coordinator - Sacramento, CA 95816 - Indeed.com FCHN