Personal Care Coordinator

CalOptima Health is seeking a highly motivated an experienced Personal Care Coordinator to join our team. The Personal Care Coordinator (Justice-Involved (JI) Liaison) will be responsible for coordinating healthcare services for members who are involved with the criminal justice system, including those who are incarcerated, on probation or recently released within the scope of the Department of Health Care Services’ Justice-Involved Reentry Initiative. The incumbent will work closely with correctional facilities, probation officers, community organizations and healthcare providers to ensure these individuals have access to necessary medical, behavioral health and social services. The incumbent will identify any barriers to members’ care and assist in improving these barriers for all levels of care. The incumbent will work closely with internal and external partners to ensure member access to timely services and coordination of care.

Position Information

• Department: Medi-Cal & CalAIM
• Salary Grade: 303 - $51,744 - $72,441 ($24.88 - $34.8274)
• Work Arrangement: Full Office
  
  

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.
• Supports correctional facilities, pre-release care managers and enhanced care management (ECM) providers to coordinate care for members as needed.
• Provides information on topics including but not limited to pre-release care manager and ECM provider assignment, managed care plan (MCP) policy pertaining to the JI population of focus (POF), prior authorization, MCP services such as community supports and non-emergency medical transportation, primary care provider (PCP) assignment and network providers.
• Provides support via phone and electronic communication during regular business hours with all incoming questions addressed within one business day.
• Enters data into CalOptima Connect portal and other CalOptima Health information systems as needed.
• Collaborates with internal and external partners to ensure timely communication of member’s clinical information.
• Supports referrals to transportation, specialists and behavioral health on behalf of members as needed.
• Notifies member’s care team of key event triggers.
• Works with internal and external partners to expedite the resolution of member concerns.
• Reviews partners’ concerns or questions that could potentially require additional support or outreach with the supervisor.
• Collaborates with healthcare providers to ensure continuity of care during transitions.
• Builds and maintains relationships with correctional facilities, probation officers and community organizations.
• Maintains knowledge on JI individuals and their healthcare options and rights.
• Ensures smooth assignment of ECM providers to eligible JI members.
• Supports department in the training and monitoring of JI ECM providers.
• Monitors activities of JI ECM providers to ensure compliance with policy guide.
• Collects and analyzes data related to the health outcomes and service utilization of JI members, and prepares reports for management and stakeholders on the impact of programs and services.
• Ensures all activities are compliant with relevant laws and regulations, including those specific to justice-involved populations.
• Keeps informed of changes in healthcare and criminal justice policies that may affect the population served.
• Maintains and updates CalOptima Health’s policy pertaining to the JI POF as needed.
• 5% - Completes other projects and duties as assigned.
  
  

Minimum Qualifications

• High school diploma PLUS 1 year of experience working with the needs of Medi-Cal members; 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 social work, human services criminal justice, healthcare administration or a related field.
• 2 years of experience in case management, social work or healthcare coordination, particularly with JI populations.
• Understanding of the criminal justice system and its impact on healthcare.
• Bilingual in English and one of CalOptima Health’s defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).
  
  

Required Licensure / Certifications

• n/a
  
  

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 February 13, 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.