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Contracts Specialist 505 City Parkway West
The Contracting Department works with many departments and all levels of CalOptima Health’s leadership and staff to support policy, process and contracting related needs.
Activity Coordinator (PACE) PACE - Garden Grove
PACE is a health services plan designed for people of age 55 and older, who have ongoing health care needs. The services provided are all inclusive and authorized by the interdisciplinary team.
Director, Credentialing (Director I) 505 City Parkway West
The Credentialing department is responsible for verifying and maintaining health care provider credentials.
Physical Therapist (PT) 505 City Parkway West
PACE is a health services plan designed for people of age 55 and older, who have ongoing health care needs. The services provided are all inclusive and authorized by the interdisciplinary team.
Supervisor Coding Initiatives (Hierarchical Condition Category) 505 City Parkway West
The Financial Analysis Department is responsible for the development of various financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions.
Provider Data Management Services Coordinator 505 City Parkway West
The Provider Data Management Services department is responsible for managing operations of the provider network to ensure timely access to care for our members.
Financial Analyst I 505 City Parkway West
The Financial Analysis Department is responsible for the development of various financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions.
Data Analyst Sr (Quality Analytics) 505 City Parkway West
Quality Analytics is responsible for working to improve performance on quality measures including clinical, access and member experience metrics. Quality Analytics works on priorities established with leadership, and collaborates with internal department business owners and external providers on strategy, reporting and interventions.
Member Liaison Specialist (Behavioral Health) 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal and OneCare Members.
Member Liaison Specialist (Behavioral Health) 505 City Parkway West
The Member Liaison Specialist (Behavioral Health) will be responsible for assisting Medi-Cal and OneCare members with behavioral health care management needs in a call center environment, which includes but is not limited to securing behavioral health appointments for members, following up with members before and after the initial appointment, providing members with information and referring to community resources and assisting member in navigating the behavioral health system of care.
Program Manager (Medicare) 505 City Parkway West
The Program Manager (Medicare) will be responsible for the coordination and maintenance of CalOptima Health’s relationships with regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) and the Department of Healthcare Services (DHCS).
Health Network Liaison Specialist (RN) 505 City Parkway West
The Case Management Department oversees CalOptima Health Case Management needs for Medi-Cal and OneCare Members and Case Management regulatory requirements.
Program Specialist (Community Relations) 505 City Parkway West
The Community Relations Department strives to strengthen partnerships by enhancing communications, understanding, and mutual support between CalOptima Health and community organizations.
Medical Case Manager RN (Emergency Department Program) 505 City Parkway West
The Medical Case Manager for Long Term Services Supports (LTSS) Emergency Department Program is part of an advanced specialty collaborative practice, responsible for case management, care coordination, authorization and utilization management of the assigned population of focus (emergency department, Community Based Adult Services (CBAS), CalAIM, complex discharge and long-term care (LTC) members residing in nursing facilities under custodial care) including members in OneCare programs, Medi-Cal only members or members living in the intermediate care facilities under regional center guidelines.
Medical Case Manager 505 City Parkway West
The Case Management Department oversees CalOptima Health Case Management needs for Medi-Cal and OneCare Members and Case Management regulatory requirements.
Medical Case Manager (Whole Child Model) 505 City Parkway West
The Case Management Department oversees CalOptima Health Case Management needs for Medi-Cal and OneCare Members and Case Management regulatory requirements.
Claims Resolution Specialist (Customer Service) 505 City Parkway West
The Claims Administration Department is responsible for managing and processing of all medical claims in accordance with industry standards and regulations, ensuring accuracy and timely reimbursement to healthcare providers.
Supervisor Claims (Operational Support-Analytics) 505 City Parkway West
The Claims Administration Department is responsible for managing and processing of all medical claims in accordance with industry standards and regulations, ensuring accuracy and timely reimbursement to healthcare providers.
Russian Translation Specialist (Translation Specialist) 505 City Parkway West
CalOptima Health’s Cultural and Linguistics (C&L) Department ensures all members have access to translation and interpretation services related to receiving health care in any language and translated member materials in CalOptima’s threshold languages.
Director, Chronic Condition Self-Management (Director III) 505 City Parkway West
The Equity and Community Health Management department engages members, providers, and community partners to reduce disparities and improve health outcomes for all CalOptima Health members.

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