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Clinician (Behavioral Health) 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal and OneCare Members.
Program Specialist (Bilingual) 505 City Parkway West
The Program Specialist for Community Health will support the coordination and implementation of Community Health programs, projects and initiatives that advance organizational goals and improve member health outcomes.
Marketing and Outreach Specialist Sr 505 City Parkway West
The Communications department is here to create, support, implement and direct CalOptima’s internal and external communications in a manner that promotes and preserves CalOptima, its mission, and strategic goals and objectives.
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.
Claims Examiner Sr, 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.
Claims Resolution Specialist, 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.
Claims Examiner Sr 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.
Claims Examiner - Lead 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.
Claims Examiner - Lead 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.
Supervisor Social Work (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.
Member Liaison Specialist 505 City Parkway West
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.
Communications Specialist 505 City Parkway West
The Communications department is here to create, support, implement and direct CalOptima’s internal and external communications in a manner that promotes and preserves CalOptima, its mission, and strategic goals and objectives.
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.
Administrative Fellow 505 City Parkway West
Under the direction of the Chief Administrative Officer, 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.
Customer Service Representative 505 City Parkway West
The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and provider with questions related to the Medi-Cal programs.
Claims Resolution Specialist - 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.
Program Specialist Sr, Community Health (Bilingual Required) 505 City Parkway West
The Program Specialist Sr for Community Health will lead the coordination of projects, pilots and initiatives that advance organizational goals, improve member health outcomes and support compliance with regulatory requirements established by the Centers for Medicare & Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care Services (DMHC) and the National Committee for Quality Assurance (NCQA).
Accounting Clerk 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.
Grievance & Appeals Nurse 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.
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.

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