Data Administrator

Location: Remote Employment Type: Full-Time Hourly Pay Range: $24 - $27 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. Overview The Data Administrator is a key individual-contributor role responsible for maintaining the integrity, accuracy, and compliance of organizational data. This position ensures timely reporting, seamless system integration, and strategic insights that support both day-to-day operations and long-term organizational growth. The role requires high attention to detail, strong organizational skills, and the ability to collaborate across teams to ensure reliable data-driven decision-making. Key Responsibilities Health Plan Compliance Submissions Oversee the monthly and quarterly submission of Enhanced Care Management (ECM) Report Template Files (RTF) and Outreach Transmission Files (OTF) to all contracted health plansGather, validate, and consolidate data from multiple internal systems, ensuring accuracy of member demographics, service dates, and case notesEnsure all submissions meet health plan-specific formatting and regulatory requirements to maintain complianceMonitor submission timelines, confirm receipt with health plans, and troubleshoot errors or rejections quickly to avoid penalties Member Eligibility and Authorization Conduct recurring eligibility checks to confirm members remain qualified for ECM, Medi-Cal, and other service programsPartner with case managers to reassess member needs and adjust service enrollments accordinglyDocument all re-qualification activities in compliance with audit standards and payer expectationsUpdate member statuses promptly to ensure accurate resource allocation and continuity of careManage the end-to-end process for obtaining initial authorizations and subsequest reauthorizations through various provider portalsTrack the status of all authorizations, maintaining detailed records of approvals, denials, and pending renewals System Data Integrity Maintain a consolidated and reliable view of all member touchpoints by duplicating Lead Care Manager (LCM) notes from TheraPlatform into SalesMateStandardize note formatting and apply appropriate tags or categories for efficient retrieval and reportingPerform regular audits to identify missing or incomplete data entries and resolve discrepancies with care teamsEnsure that data captured across platforms supports continuity of care and enhances leadership visibility Leadership Reporting Compile weekly updates on member statuses, including active, pending, and closed cases, and distribute to executive and leadership teamsTrack and highlight trends such as outreach completion rates, reassessment activity, and engagement levelsTranslate raw data into actionable insights that enable leadership to make timely, data-driven decisionsDeliver clear reports to multiple stakeholders, including department heads, sales teams, and executive leadership Member Profile Oversight Review and update member profiles regularly to ensure active/inactive statuses are correct and align with real-time service deliveryConfirm discharge reasons, service end dates, and member transitions are fully documented for complianceFlag discrepancies proactively and work directly with care teams to resolve errorsMaintain health plan compliance standards by ensuring member record integrity and audit readiness Operational Reporting Produce recurring weekly and monthly reports to monitor organizational performance and complianceTrack key indicators such as member counts, service utilization, eligibility changes, and program engagement ratesProvide tailored progress reports to leadership or external partners to demonstrate accountabilitySupport internal audits and quality improvement initiatives by providing clear, accurate, and timely data Research & Expansion Insights Aggregate demographic, economic, and healthcare utilization data to identify new regions for community-based program expansionConduct in-depth research on local regulations, health plan coverage, and community needs to ensure successful placementBuild and maintain structured databases of potential partners, community events, and opportunities for organizational outreachValidate data sources for accuracy and reliability to support leadership in making informed, evidence-based decisions Event Planning & Outreach Support Research and curate a calendar of community events, conferences, and networking opportunities aligned with organizational goalsAssess the strategic value of events based on target populations, potential partnerships, and visibility opportunitiesPartner with internal teams to coordinate event participation, including logistics, staffing, and materialsTrack outcomes and engagement metrics post-event to evaluate return on investment and guide future planning Other Duties as Assigned Support evolving priorities by assisting with data system implementations, migrations, and workflow redesignsParticipate in special projects such as large-scale data audits or compliance-focused reviewsHelp onboard and train new staff in data procedures, system use, and reporting protocolsWork 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 preferredProficiency with CRM platforms, reporting dashboards, and data entry tools (TheraPlatform, SalesMate a plus)Strong analytical, organizational, and problem-solving skillsAbility to communicate clearly with executives, managers, and cross-functional teamsPreferred: Familiarity with Medi-Cal, ECM, CalAIM, and health plan compliance processes Benefits 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 employment4 Paid Volunteer Hours per Month to support causes you care aboutBereavement Leave, including Fur Baby Bereavement Health & Wellness 90% Employer-paid Employee-Only Medical BenefitsFlexible Spending Account (FSA)Short-Term & Long-Term Disability | AD&DEmployee Assistance Program (EAP) Financial & Professional 401(k) with Company MatchMonthly StipendOpportunities for professional development and internal growth Culture & Perks Employee Discounts via Great Work Perks and Perks at WorkQuarterly 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.