Location: Remote – CA
Employment Type: Full-Time
Hourly Pay Range: $21 – $24 per hour
About Pacific Health Group
At Pacific Health Group, we are at the forefront of revolutionizing healthcare. You will play a vital role in this mission. We are dedicated to improving health outcomes by addressing social determinants of health and coordinating comprehensive community-based services, particularly through our programs. If you are passionate about making a difference and have the skills to lead in this dynamic environment, we invite you to join our team.
Key Responsibilities1) Member Assessments & Care Coordination
- Conduct trauma-informed needs assessments to understand each member’s health and social needs.
- Review medical and social histories to determine eligibility for programs such as Enhanced Care Management (ECM).
- Coordinate with Lead Care Managers and other departments to initiate and maintain care plans.
- Ensure thorough and timely documentation in PHG’s systems.
2) Referral Management
- Facilitate referrals to internal and external providers, ensuring timely access to care and community resources.
- Communicate with clinics, specialists, and community-based organizations to confirm successful engagement.
- Track and close referral loops, identifying and addressing barriers as needed.
3) Virtual Member Support
- Serve as the main contact for assigned members via phone and virtual check-ins.
- Provide follow-up coordination and ensure continuity of care across multiple programs.
- Collaborate with care managers, healthcare providers, and family members to address challenges and maintain engagement.
4) Quality & Documentation
- Maintain accurate, HIPAA-compliant records across systems.
- Audit data for completeness and collaborate on quality improvement initiatives.
- Collect member feedback to identify opportunities to enhance service delivery.
5) Outreach & Engagement Support
- Follow up with members identified through outreach or marketing campaigns.
- Confirm interest, schedule assessments, and collect any required documentation.
- Provide feedback to outreach and care teams to strengthen engagement workflows.
6) Member Re-Engagement & Disenrollment
- Identify inactive members and conduct structured re-engagement outreach via phone, text, and email.
- Reconnect interested members to Lead Care Managers or complete disenrollment processes as needed.
- Maintain documentation to ensure compliance with health plan and reporting standards.
- 2+ years of experience in healthcare coordination, case management, or member services.
- Strong organizational, communication, and problem-solving skills.
- Proficiency with CRM systems and healthcare databases.
- Attention to detail and comfort working in high-volume environments.
- Familiarity with Medi-Cal, CalAIM, and HIPAA standards preferred.
Time Off & Leave
- 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
Health & Wellness
- 90% Employer-paid Employee-Only Medical Benefits
- Flexible Spending Account (FSA)
- Short-Term & Long-Term Disability | AD&D
- Employee Assistance Program (EAP)
Financial & Professional
- 401(k) with Company Match
- Monthly Stipend
- Opportunities for professional development and internal growth
Culture & Perks
- Employee Discounts via Great Work Perks and Perks at Work
- Quarterly In-Person Events
Equal Opportunity Employer
Pacific Health Group is an Equal Opportunity Employer. We are committed to creating an inclusive and equitable workplace where all individuals are treated with dignity and respect. 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.
Job Application & Offer Disclaimer
Pacific Health Group is committed to maintaining a transparent, lawful, and secure hiring process in compliance with California labor laws and employment standards. No candidate will be offered employment without meeting the required qualifications and skillset for the position and successfully completing all steps of our recruitment process, which include:
• Submission of a completed internal application via our HRIS system
• A formal pre-screen with our recruiting team
• Completion of a skills assessment (if applicable to the position)
• Participation in a final interview with hiring leadership
• Receipt of a formal verbal offer from our authorized hiring team
AI & Human Interaction (HI) in Recruitment
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.
All resumes that meet these criteria are then reviewed by HI (Human Interaction) — our recruiting and HR team. Pacific Health Group remains true to our Equal Employment Opportunity (EEO) statement, ensuring that every candidate is given fair and consistent consideration.
