Data Administrator

Description Location: Remote Employment Type: Full-Time Hourly Pay Range: $24 – $27 per hour About Pacific Health GroupAt 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 SubmissionsOversee 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.
• Member Eligibility and AuthorizationConduct 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.
• Manage the end-to-end process for obtaining initial authorizations and subsequest reauthorizations through various provider portals.
• Track the status of all authorizations, maintaining detailed records of approvals, denials, and pending renewals.
• System Data IntegrityMaintain a consolidated and reliable view of all member touchpoints by duplicating Lead Care Manager (LCM) notes from TheraPlatform into SalesMate.

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

• Time Off & Leave160 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 BereavementHealth & Wellness90% Employer-paid Employee-Only Medical

Benefits

• Flexible Spending Account (FSA)Short-Term & Long-Term Disability | AD&DEmployee Assistance Program (EAP)Financial & Professional401(k) with Company MatchMonthly StipendOpportunities for professional development and internal growthCulture & PerksEmployee Discounts via Great Work Perks and Perks at WorkQuarterly In-Person EventsEqual 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 DisclaimerPacific Health Group is committed to maintaining a transparent, lawful, and secure hiring process in compliance with 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: