Data Administrator

Pacific Health Group is at the forefront of revolutionizing healthcare, and they are seeking a Data Administrator to maintain the integrity, accuracy, and compliance of organizational data. The role involves overseeing data submissions, conducting eligibility checks, ensuring data integrity, and providing leadership reporting to support operational growth.ResponsibilitiesOversee the monthly and quarterly submission of Enhanced Care Management (ECM) Report Template Files (RTF) and Outreach Transmission Files (OTF) to all contracted health plansGather, validate, and consolidate data from multiple internal systems, ensuring accuracy of member demographics, service dates, and case notesEnsure all submissions meet health plan-specific formatting and regulatory requirements to maintain complianceMonitor submission timelines, confirm receipt with health plans, and troubleshoot errors or rejections quickly to avoid penaltiesConduct recurring eligibility checks to confirm members remain qualified for ECM, Medi-Cal, and other service programsPartner with case managers to reassess member needs and adjust service enrollments accordinglyDocument all re-qualification activities in compliance with audit standards and payer expectationsUpdate member statuses promptly to ensure accurate resource allocation and continuity of careMaintain a consolidated and reliable view of all member touchpoints by duplicating Lead Care Manager (LCM) notes from TheraPlatform into SalesMateStandardize note formatting and apply appropriate tags or categories for efficient retrieval and reportingPerform regular audits to identify missing or incomplete data entries and resolve discrepancies with care teamsEnsure that data captured across platforms supports continuity of care and enhances leadership visibilityCompile weekly updates on member statuses, including active, pending, and closed cases, and distribute to executive and leadership teamsTrack and highlight trends such as outreach completion rates, reassessment activity, and engagement levelsTranslate raw data into actionable insights that enable leadership to make timely, data-driven decisionsDeliver clear reports to multiple stakeholders, including department heads, sales teams, and executive leadershipReview and update member profiles regularly to ensure active/inactive statuses are correct and align with real-time service deliveryConfirm discharge reasons, service end dates, and member transitions are fully documented for complianceFlag discrepancies proactively and work directly with care teams to resolve errorsMaintain health plan compliance standards by ensuring member record integrity and audit readinessProduce recurring weekly and monthly reports to monitor organizational performance and complianceTrack key indicators such as member counts, service utilization, eligibility changes, and program engagement ratesProvide tailored progress reports to leadership or external partners to demonstrate accountabilitySupport internal audits and quality improvement initiatives by providing clear, accurate, and timely dataAggregate demographic, economic, and healthcare utilization data to identify new regions for community-based program expansionConduct in-depth research on local regulations, health plan coverage, and community needs to ensure successful placementBuild and maintain structured databases of potential partners, community events, and opportunities for organizational outreachValidate data sources for accuracy and reliability to support leadership in making informed, evidence-based decisionsResearch and curate a calendar of community events, conferences, and networking opportunities aligned with organizational goalsAssess the strategic value of events based on target populations, potential partnerships, and visibility opportunitiesPartner with internal teams to coordinate event participation, including logistics, staffing, and materialsTrack outcomes and engagement metrics post-event to evaluate return on investment and guide future planningSupport evolving priorities by assisting with data system implementations, migrations, and workflow redesignsParticipate in special projects such as large-scale data audits or compliance-focused reviewsHelp onboard and train new staff in data procedures, system use, and reporting protocolsWork cross-functionally with IT to troubleshoot system issues and optimize workflowsSkillsBachelor's degree in data management, healthcare administration, information systems, or related field (or equivalent experience)Experience in healthcare data administration, reporting, or compliance strongly preferredProficiency with CRM platforms, reporting dashboards, and data entry tools (TheraPlatform, SalesMate a plus)Strong analytical, organizational, and problem-solving skillsAbility to communicate clearly with executives, managers, and cross-functional teamsFamiliarity with Medi-Cal, ECM, CalAIM, and health plan compliance processesBenefits160 Hours of Paid Time Off (PTO)12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment4 Paid Volunteer Hours per Month to support causes you care aboutBereavement Leave, including Fur Baby Bereavement90% Employer-paid Employee-Only Medical BenefitsFlexible Spending Account (FSA)Short-Term & Long-Term Disability | AD&DEmployee Assistance Program (EAP)401(k) with Company MatchMonthly StipendOpportunities for professional development and internal growthEmployee Discounts via Great Work Perks and Perks at WorkQuarterly In-Person EventsCompany OverviewPacific Health Group delivers integrated Medi-Cal healthcare, behavioral health, and telehealth services tailored to individual needs. It was founded in 2023, and is headquartered in Carlsbad, California, USA, with a workforce of 51-200 employees. Its website is https://mypacifichealth.com.



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