CalOptima Health is seeking a highly motivated an experienced
Personal Care Coordinator Sr to join our team. The Personal Care Coordinator Sr will perform a wide variety of advanced support activities for plan members. The incumbent will ensure regular communication of the member’s annual Health Needs Assessment (HNA) or Health Risk Assessment (HRA) and care plan with the member, primary care provider (PCP) and health care team. The incumbent will regularly assess the quality of service given to the member’s care by identifying barriers and assisting in improving these barriers for all levels of care. The incumbent will maintain strong working relationships with the PCP and health care team to ensure member access to timely services and coordination of care.
Position Information
- Department: Case Management
- Salary Grade: 304 - $53,813 - $80,720 ($25.87 - $38.8077)
- Work Arrangement: Full Telework
- This position is eligible for telework in California.**
Duties & Responsibilities - 95% - Program Support
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Maintains strong working relationships when collaborating with the PCP and health care team to ensure timely communication of member’s clinical information and ensures appropriate documentation of all interventions. Also, notifies member’s care team of key event triggers.
- Collaborates with licensed professionals in development of a care plan for each member, incorporating the HNA or HRA all assessment findings. Facilitates communication of care plan to the PCP and member, as necessary.
- Develops and implements a member’s specific care plan which includes prioritized Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) goals.
- Facilitates and participates in interdisciplinary team meetings as applicable.
- Processes and maintains complex or sensitive documentation of member’s case and care plan within CalOptima Health’s medical management system.
- Facilitates referrals to Behavioral Health Services and identifies the need for referrals to Long-Term Support Services and community resources.
- Facilitates transfers to member’s assigned case manager in accordance with member needs, when appropriate.
- Anticipates longer-term and more unique member needs by providing guidance in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, as appropriate.
- Maintains compliance with established departmental productivity guidelines; compiles and conducts basic analyses and reporting of productivity metrics to management as required.
- Coordinates and maintains cases in current case load in accordance with case management standards. Assists with collection of health risk or health needs assessments as well as gathers medical records as needed.
- Provides regular outreach to assigned members and evaluates quality of service given to members according to department contact standards.
- Serves as the main point of contact for assigned members to anticipate longer term member needs.
- Works with Case Management staff to expedite the resolution of member concerns.
- 5% - Completes other projects and duties as assigned.
Minimum Qualifications
- High School diploma or equivalent required PLUS 2 years of experience working with the needs of members, such as but not limited to pediatric members, seniors or persons with disabilities (SPD) and/or special populations (e.g., homeless or at risk of homelessness) in a customer/member service capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred Qualifications
- Bachelor’s degree in healthcare management, social work, human services or related field.
- 2 years of experience with health maintenance organization (HMO), Medi-Cal and health services.
- Experience working with individuals with behavior health conditions or substance use disorders.
- Bilingual in English and one of CalOptima Health’s defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).
Required Licensure / Certifications
Knowledge & Abilities
- Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
- Work independently and exercise sound judgment.
- Communicate clearly and concisely, both orally and in writing.
- Work a flexible schedule; available to participate in evening and weekend events.
- Organize, be analytical, problem-solve and possess project management skills.
- Work in a fast-paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi-program teams and external committees/coalitions.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With Or Without Accommodations)
- Ability to visually read information from computer screens, forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Work Environment
If located at the 500, 505 Building or a remote work location:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- There are no harmful environmental conditions present for this job.
- The noise level in this work environment is usually moderate.
If Located At PACE
- Work is typically indoors in a clinical setting serving the frail and elderly.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud.
If Located In The Community
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- Employee will occasionally work outdoors in varied temperatures.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud.
About CalOptima Health
CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto — "Better. Together.” — is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community’s health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County’s best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!
About Our Benefits & Wellness Options
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the
2025 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.
IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS
Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is
January 27, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.
The selection process may include, but is not limited to, a skills assessment, phone screen and interview.
The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.
Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
