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ITS Architect IV (Release Train Engineer/SDLC Architect)
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505 City Parkway West
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| The ITS Architect IV (Release Train Engineer/Agile Software Development Life Cycle (SDLC)) will define the enterprise Agile Release Trains (ARTs) and SDLC methodology for CalOptima Health to enhance team collaboration, cross-functionality and delivery efficiency. |
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Communications Specialist, Sr.
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505 City Parkway West
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| The Communications Specialist Sr will write, create, edit and produce materials to ensure effective internal and external communication for CalOptima Health’s programs and activities. |
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Member Liaison Specialist (Customer Service) - Bilingual
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505 City Parkway West
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| The Member Liaison Specialist (Customer Service) will provide member service to seniors, persons with disabilities or chronic conditions, persons without housing and persons under the age of twenty-one (21) who participate in the Whole-Child Model program. |
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Customer Service Representative Sr (OneCare) (Bilingual Required)
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505 City Parkway West
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| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and providers with questions related to the OneCare Plan services. |
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Customer Service Representative, Sr. (General)
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505 City Parkway West
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| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and provider with questions related to the Med-Cal programs. |
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Customer Service Representative (General)
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505 City Parkway West
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| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and provider with questions related to the Med-Cal programs. |
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Social Worker (PACE)
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PACE - Garden Grove
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| 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. |
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Community Relations Specialist (Bilingual Spanish Required)
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505 City Parkway West
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| The Community Relations Department strives to strengthen partnerships by enhancing communications, understanding, and mutual support between CalOptima Health and community organizations. |
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Intern (Facilities)
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505 City Parkway West
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| The Environmental Health & Safety (EH&S) Facilities department for building operations ensures that all physical infrastructure complies with safety, health, and environmental regulations. It manages building inspections, hazardous materials handling, emergency systems, and routine maintenance to minimize risks and ensure occupant safety. The team also supports sustainability efforts through energy efficiency, waste reduction, and environmentally responsible facility practices. |
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Provider Relations Rep
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505 City Parkway West
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| The Provider Relations group is responsible for managing operations of the provider network to ensure timely access to care for our members. |
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Program Assistant (Credentialing)
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505 City Parkway West
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| CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities. |
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Executive Assistant
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505 City Parkway West
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| The Executive Assistant will provide multi-faceted administrative support and assistance to the Chief and/or Executive Director (Executive). |
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Lead Decision Support Analyst (Principal Financial Analyst)
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505 City Parkway West
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| The Principal Financial Analyst (Decision Support) will be responsible for providing highly complex analysis, guidance and expert knowledge on health care finance for various departments within CalOptima Health. |
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Administrative Assistant (PACE Clinic - Scheduler)
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PACE - Garden Grove
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| 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. |
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Auditor Sr (Non-Clinical)
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505 City Parkway West
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| The Auditor Sr (Non-Clinical) will conduct routine oversight, monitoring and auditing of all internal business functions within CalOptima Health (non-clinical) to ensure compliance with state, federal and accreditation standards. |
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Director, Enrollment & Billing (Director II)
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505 City Parkway West
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| CalOptima Health is looking for a strategic thinker with a proven track record of leading a high-performing team to establish and manage the Enrollment and Billing function related to Health Insurance Exchange/Marketplace/Covered California product operations. |
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Personal Care Attendant
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PACE - Garden Grove
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| 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. |
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Administrative Fellow
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505 City Parkway West
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| Under the direction of Executive Leadership (e.g., Chief Executive Officer, Chief Medical Officer, Chief Operating Officer, Chief Information Officer, Chief Financial Officer, etc.) the Administrative Fellow (Fellow) will work with key administrative personnel to gain knowledge and experience in the management of CalOptima Health, as well as the broader health care landscape. |
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Clinical Pharmacist
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505 City Parkway West
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| Pharmacy Management provides strategic leadership and operational oversight for all aspects of pharmacy services within a managed care organization. |
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Certified Coding Specialist
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505 City Parkway West
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| The Coding Team collaborates with the Claims Administration team to identify process improvement opportunities to increase department efficiencies. Ensures current coding methodology and modifier rules are appropriately applied for accurate claim reimbursement. Assists CalOptima Health Business Units regarding conflicting, ambiguous, or non-specific medical documentation identified regarding coding protocol and Medi-Cal or Medicare fee schedules/rates. Conducts coding validation of submitted claims, which includes, but is not limited to, review of professional, inpatient, and outpatient claims data and or medical records to determine appropriateness of procedures and diagnosis codes billed. Provides analytical support and technical expertise on requests from CalOptima Health Business Units regarding claims processing or claims program-related implementation. |