Service Desk Administrator at SambaSafety providing exceptional IT support and resolving customer issues for onsite and remote users in a fast - paced environment.
About the role
- Data Administrator maintaining data integrity, ensuring compliance, and supporting healthcare initiatives at Pacific Health Group.
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.
Requirements
- 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.
- Preferred: 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
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