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Current opportunities

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Sr. Data Analyst, Covered CA Enrollment and Premium Billing (Data Analyst Sr) 505 City Parkway West
The Data Analyst Sr for Covered California Enrollment and Billing will provide advanced technical expertise across all data reporting and analysis functions, including database development, maintenance and process implementation.
Clinical Pharmacist, Clinical and Quality Programs 505 City Parkway West
Pharmacy Management provides strategic leadership and operational oversight for all aspects of pharmacy services within a managed care organization.
Customer Service Rep, Covered California 505 City Parkway West
The Customer Service Rep (Covered CA) will be the first line of contact for CalOptima Health’s members and providers.
Manager Customer Service, Covered CA Call Center 505 City Parkway West
Seeking qualified applicants for the Manager Customer Service (Covered CA - Call Center) role. The Manager Customer Service (Covered CA – Call Center) will manage and oversee the daily operations of all call center activities and staff.
Manager Quality Improvement, PQI 505 City Parkway West
CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities.
Engagement & Partnerships Representative (Community Relations Specialist) 505 City Parkway West
The Community Relations Specialist (Engagement & Partnerships Representative) is responsible for executing local and provider-focused engagement strategies to strengthen member relationships, raise awareness of CalOptima Health’s Medicare Advantage/OneCare offerings, and support retention goals.
Behavioral Health Utilization Management Medical Case Manager 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal and OneCare Members.
Grievance Resolution Specialist Sr (Provider Resolution) 505 City Parkway West
The Grievance and Appeals Resolution Services (GARS) Department is responsible for coordinating thorough reviews to provide appropriate resolutions to verbal and written complaints, appeals and disputes for both members and providers.
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.
Sr. Accounts Payable Clerk (Accounting Clerk Sr) 505 City Parkway West
The Accounting area monitors the plan’s financial condition through external audits of financial data and ensures compliance with federal and state regulations and tax filing requirements.
Business Analyst, Enrollment and Premium Billing 505 City Parkway West
The Business Analyst-Enrollment and Premium Billing will be responsible for supporting the development, implementation and ongoing operationalization of Covered California enrollment and premium billing functions for CalOptima Health.
Program Assistant, Grievance & Appeals 505 City Parkway West
The Grievance and Appeals Resolution Services (GARS) Department is responsible for coordinating thorough reviews to provide appropriate resolutions to verbal and written complaints, appeals and disputes for both members and providers.
Program Assistant, Enrollment - Medi-Cal 505 City Parkway West
This position supports Medi-Cal program operations by assisting with member enrollment processes, eligibility analysis, and provider assignments while ensuring accuracy and regulatory compliance. The role works closely with cross-functional teams to process member requests, respond to policy-related inquiries, prepare reports, and support audits and quality assurance activities. Ideal candidates are detail-oriented, collaborative, and committed to delivering high-quality service that positively impacts our members.
Sr. Investigator, Fraud, Waste and Abuse 505 City Parkway West
Under general direction, the Investigator Sr for Fraud, Waste & Abuse (FWA) will support the detection, prevention, investigation, mitigation and reporting of FWA issues.
Sr Program Specialist, Medi-Cal & CalAIM 505 City Parkway West
CalAIM is a transformative five-year initiative redefining Medi-Cal to enhance members’ health outcomes and quality of life. By addressing social drivers of health and delivering comprehensive whole-person care, CalAIM provides coordinated services for physical, behavioral and long-term care needs. With a focus on equity and prevention, it extends critical support into communities, better serving California’s most vulnerable populations, including those experiencing homelessness, seniors and children with complex medical needs.