DBA Admin

Pacific Health Group; Nevada; Teletrabalho; USD 33 000 - 37 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

90% Employer-paid Medical Benefits

Flexible Spending Account (FSA)

Disability | AD&D

Employee Assistance Program (EAP)

Bereavement Leave

Resumo da oferta

Pacific Health Group is seeking a data-focused professional to manage ECM/OTF submissions, validate multi-system data, and ensure regulatory compliance. You will generate reports, analyze trends, and support leadership with timely insights.

You will collaborate with IT and care teams, participate in system improvements, and help expand community outreach through accurate data handling.

Qualificações

• Bachelor’s degree in data management, healthcare administration, information systems, or related field (or equivalent experience).
• Experience in healthcare data administration, reporting, or compliance strongly preferred.
• Proficiency with CRM platforms, reporting dashboards, and data entry tools (TheraPlatform, SalesMate a plus).
• Preferred: Familiarity with Medi-Cal, ECM, CalAIM, and health plan compliance processes.
• 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment.

Responsabilidades

• Oversee the monthly and quarterly submission of Enhanced Care Management (ECM) Report Template Files (RTF) and Outreach Transmission Files (OTF) to all contracted health plans.
• Gather, validate, and consolidate data from multiple internal systems, ensuring accuracy of member demographics, service dates, and case notes.
• Ensure all submissions meet health plan-specific formatting and regulatory requirements to maintain compliance.
• Monitor submission timelines, confirm receipt with health plans, and troubleshoot errors or rejections quickly to avoid penalties.
• Document all re-qualification activities in compliance with audit standards and payer expectations.
• Perform regular audits to identify missing or incomplete data entries and resolve discrepancies with care teams.
• Translate raw data into actionable insights that enable leadership to make timely, data-driven decisions.
• Produce recurring weekly and monthly reports to monitor organizational performance and compliance.
• Aggregate demographic, economic, and healthcare utilization data to identify new regions for community-based program expansion.
• Conduct in-depth research on local regulations, health plan coverage, and community needs to ensure successful placement.
• Build and maintain structured databases of potential partners, community events, and opportunities for organizational outreach.
• Validate data sources for accuracy and reliability to support leadership in making informed, evidence-based decisions.

Conhecimentos

Data management

Data reporting

Regulatory compliance

Cross-functional collaboration

Formação académica

Bachelor degree in data management or related field

Ferramentas

TheraPlatform

SalesMate

Descrição da oferta de emprego

Location: Remote
Employment Type: Full-Time
Hourly Pay Range: $24 – $27 per hour

About Pacific Health Group

At Pacific Health Group, we are at the forefront of revolutionizing healthcare. We are dedicated to improving health outcomes by addressing social determinants of health and coordinating comprehensive community-based services, particularly through our programs.

Health Plan Compliance Submissions

• Oversee the monthly and quarterly submission of Enhanced Care Management (ECM) Report Template Files (RTF) and Outreach Transmission Files (OTF) to all contracted health plans.
• Gather, validate, and consolidate data from multiple internal systems, ensuring accuracy of member demographics, service dates, and case notes.
• Ensure all submissions meet health plan-specific formatting and regulatory requirements to maintain compliance.
• Monitor submission timelines, confirm receipt with health plans, and troubleshoot errors or rejections quickly to avoid penalties.
• Document all re-qualification activities in compliance with audit standards and payer expectations.

System Data Integrity

• Perform regular audits to identify missing or incomplete data entries and resolve discrepancies with care teams.
• Ensure that data captured across platforms supports continuity of care and enhances leadership visibility.
• Track and highlight trends such as outreach completion rates, reassessment activity, and engagement levels.
• Translate raw data into actionable insights that enable leadership to make timely, data-driven decisions.
• Confirm discharge reasons, service end dates, and member transitions are fully documented for compliance.
• Maintain health plan compliance standards by ensuring member record integrity and audit readiness.
• Produce recurring weekly and monthly reports to monitor organizational performance and compliance.
• Support internal audits and quality improvement initiatives by providing clear, accurate, and timely data.
• Aggregate demographic, economic, and healthcare utilization data to identify new regions for community-based program expansion.
• Conduct in-depth research on local regulations, health plan coverage, and community needs to ensure successful placement.
• Build and maintain structured databases of potential partners, community events, and opportunities for organizational outreach.
• Validate data sources for accuracy and reliability to support leadership in making informed, evidence-based decisions.

Event Planning & Outreach Support

• Research and curate a calendar of community events, conferences, and networking opportunities aligned with organizational goals.
• Assess the strategic value of events based on target populations, potential partnerships, and visibility opportunities.
• Partner with internal teams to coordinate event participation, including logistics, staffing, and materials.
• Support evolving priorities by assisting with data system implementations, migrations, and workflow redesigns.
• Participate in special projects such as large-scale data audits or compliance-focused reviews.
• Help onboard and train new staff in data procedures, system use, and reporting protocols.
• Work cross-functionally with IT to troubleshoot system issues and optimize workflows.

Qualifications

• Bachelor’s degree in data management, healthcare administration, information systems, or related field (or equivalent experience).
• Experience in healthcare data administration, reporting, or compliance strongly preferred.
• Proficiency with CRM platforms, reporting dashboards, and data entry tools (TheraPlatform, SalesMate a plus).
• Preferred: Familiarity with Medi-Cal, ECM, CalAIM, and health plan compliance processes.
• 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment.

Benefits

• 90% Employer-paid Employee-Only Medical Benefits
• Flexible Spending Account (FSA)
• Short-Term & Long-Term Disability | AD&D
• Employee Assistance Program (EAP)
• Bereavement Leave, including Fur Baby Bereavement

Financial & Professional

• All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender, gender identity or gender expression, sexual orientation, national origin or ancestry, citizenship status, physical or mental disability, medical condition (including cancer and genetic characteristics), age (40 and over), marital status, military or veteran status, genetic information, or status as a victim of domestic violence, assault, or stalking. We value diversity in all forms and encourage individuals from historically underrepresented communities to apply.

Pacific Health Group is committed to fairness, equity, and transparency in our hiring practices. We use AI (Artificial Intelligence) tools to help match candidate resumes against our job descriptions, focusing on qualifications, skillsets, and location.