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AI Solutions Analyst (ITS Analyst Sr) 505 City Parkway West
Help shape how CalOptima Health puts AI to work for its members. As an AI Solutions Analyst, you will help identify and shape high-value AI opportunities, turn business needs into responsible and measurable solutions, and work alongside clinical, quality, and operations leaders to bring the right ideas forward. If you are energized by making AI useful, trustworthy, and meaningful, we want to hear from you.
AI Solutions Engineer (ITS Architect III) 505 City Parkway West
Help turn promising AI opportunities into reliable solutions at CalOptima Health. As an AI Solutions Engineer, you will take approved use cases from concept to production, bringing together the right mix of technology, engineering, and vendor capabilities to deliver solutions that scale. If you want to build practical AI that creates meaningful value in a mission-driven healthcare organization, we want to hear from you.
Clinical Data & Reporting Analyst (Data Warehouse Reporting Analyst Sr) 505 City Parkway West
IT provides best-in-class technology solutions that enhance the health outcomes of our members and the community we serve.
Financial Analyst III (Financial Reporting) 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.
Sr. Clinical Solutions Engineer (ITS Architect III) 505 City Parkway West
IT provides best-in-class technology solutions that enhance the health outcomes of our members and the community we serve.
Supervisor Customer Service, Member Enrollment 505 City Parkway West
The Enrollment & Reconciliation team supports Medi-Cal and Medicare programs by processing member enrollment, eligibility and maintenance transactions. The team ensures compliance with regulatory requirements and works closely with internal and external partners to provide accurate and timely member enrollment services.
X - As-Needed / Temp - Talent Staffing Representative (Human Resources Representative) 505 City Parkway West
The Human Resources department believes happy employees are key to our success. We're seeking a passionate HR professional to champion talent acquisition, drive positive culture, and help us grow and thrive. Come be a part of our story and make a real impact!
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.
Grievance Resolution Specialist 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.
Financial Analyst I, Budgeting 505 City Parkway West
The Budget Department is responsible for planning, developing and managing the financial resources of the organization. The main responsibilities include developing and managing annual operating budgets and providing insights and recommendations to support strategic decision-making.
Actuarial Analyst 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, and participate in annual budgeting functions.
ITS Analyst Sr, Configuration, Covered California 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.
Sr Clinical Data Engineer (ITS Architect III) 505 City Parkway West
IT provides best-in-class technology solutions that enhance the health outcomes of our members and the community we serve.
Medical Case Manager, CalAIM (RN) 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.
Quality Improvement Specialist , Risk Adjustment, Covered California 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.
Y As-Needed / Temp Human Resources Assistant (File Room) 505 City Parkway West
The Human Resources department believes happy employees are key to our success. We're seeking a passionate HR professional to champion talent acquisition, drive positive culture, and help us grow and thrive. Come be a part of our story and make a real impact!
Y - As Needed / Temp - Program Assistant (GARS) 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.
Business Analyst Sr, Claims, Covered California 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.
Chief Operating Officer (COO) 505 City Parkway West
The Executive Office oversees the agency's operations and provides strategic vision.
Medical Case Manager (LVN) (PACE - Utilization Management) 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.

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