Remote Data & Compliance Coordinator

Pacific Health Group; Crystal Bay (NV); Remote; USD 33,000 - 37,000; Full time

Benefits offered by this job

90% Employer-paid Employee-Only Medial

Flexible Spending Account (FSA)

Short-Term & Long-Term Disability | AD

Employee Assistance Program (EAP)

Bereavement Leave, including Fur Baby

Job summary

Pacific Health Group is seeking a data-focused professional for Health Plan Compliance Submissions and System Data Integrity. You will oversee ECM/OTF file submissions, validate data accuracy across systems, and ensure regulatory alignment to prevent penalties.

You will also translate data into actionable insights, monitor trends, and support audits and quality initiatives. Remote, full-time role with strong emphasis on data governance and cross-functional collaboration.

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.

Responsibilities

• Oversee the monthly and quarterly submission of 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.

Skills

Healthcare data administration

Data reporting

Compliance awareness

Medi-Cal familiarity

Education

Bachelor’s degree in data management or healthcare admin

Tools

TheraPlatform

SalesMate

Job description

Pacific Health Group is seeking a data-focused professional for Health Plan Compliance Submissions and System Data Integrity. You will oversee ECM/OTF file submissions, validate data accuracy across systems, and ensure regulatory alignment to prevent penalties.

You will also translate data into actionable insights, monitor trends, and support audits and quality initiatives. Remote, full-time role with strong emphasis on data governance and cross-functional collaboration.