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. This role involves ensuring timely reporting and strategic insights to support both day-to-day operations and long-term organizational growth. Responsibilities - 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 - Conduct recurring eligibility checks to confirm members remain qualified for ECM, Medi-Cal, and other service programs - Partner with case managers to reassess member needs and adjust service enrollments accordingly - Document all re-qualification activities in compliance with audit standards and payer expectations - Update member statuses promptly to ensure accurate resource allocation and continuity of care - Maintain a consolidated and reliable view of all member touchpoints by duplicating Lead Care Manager (LCM) notes from TheraPlatform into SalesMate - Standardize note formatting and apply appropriate tags or categories for efficient retrieval and reporting - 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 - Compile weekly updates on member statuses, including active, pending, and closed cases, and distribute to executive and leadership teams - 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 - Deliver clear reports to multiple stakeholders, including department heads, sales teams, and executive leadership - Review and update member profiles regularly to ensure active/inactive statuses are correct and align with real-time service delivery - Confirm discharge reasons, service end dates, and member transitions are fully documented for compliance - Flag discrepancies proactively and work directly with care teams to resolve errors - 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 - Track key indicators such as member counts, service utilization, eligibility changes, and program engagement rates - Provide tailored progress reports to leadership or external partners to demonstrate accountability - 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 - 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 - Track outcomes and engagement metrics post-event to evaluate return on investment and guide future planning - 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 Skills - 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) - Strong analytical, organizational, and problem-solving skills - Ability to communicate clearly with executives, managers, and cross-functional teams - Familiarity with Medi-Cal, ECM, CalAIM, and health plan compliance processes Benefits - 160 Hours of Paid Time Off (PTO) - 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment - 4 Paid Volunteer Hours per Month to support causes you care about - Bereavement Leave, including Fur Baby Bereavement - 90% Employer-paid Employee-Only Medical Benefits - Flexible Spending Account (FSA) - Short-Term & Long-Term Disability | AD&D - Employee Assistance Program (EAP) - 401(k) with Company Match - Monthly Stipend - Opportunities for professional development and internal growth - Employee Discounts via Great Work Perks and Perks at Work - Quarterly In-Person Events Company Overview - Pacific 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.