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