Job Description Job Description
Duration: 6+ Months
Schedule: Monday through Friday; 8:00 a.m. to 5:00 p.m
Summary- The role primarily focuses on providing administrative, operational, and program support for the Medi-Cal Enrollment Department at CalOptima Health. The position ensures accurate member enrollment records, eligibility verification, provider assignments, data reconciliation, and compliance with healthcare regulations.
- The individual will work closely with internal departments, healthcare providers, insurance carriers, and members to resolve enrollment-related issues, maintain accurate member information, conduct quality assurance audits, and support daily program operations.
- This role requires strong analytical, organizational, communication, and customer service skills, along with proficiency in Microsoft Office, particularly Excel.
Work Responsibilities- Provide operational and administrative support to the Medi-Cal Enrollment Department.
- Review and verify member eligibility, enrollment information, and provider assignments.
- Process member requests, including health network changes, PCP changes, and demographic updates.
- Perform data reconciliation, quality assurance audits, and reporting activities.
- Ensure enrollment processes comply with Medi-Cal policies and regulatory requirements.
- Communicate with members, healthcare providers, insurance carriers, and internal departments.
- Maintain accurate records, documentation, workflows, and departmental procedures.
- Conduct member outreach and follow up on enrollment-related concerns.
- Support returned mail processing, member surveys, and other enrollment administration activities.
- Assist with special projects and departmental initiatives.
Required Skills- Analytical and problem-solving skills: Ability to review eligibility information, identify discrepancies, and resolve data-related issues.
- Microsoft Office proficiency: Working knowledge of Excel, Word, Outlook, and PowerPoint.
- Data management: Ability to perform data reconciliation, sorting, filtering, merging, and report preparation.
- Communication skills: Strong verbal and written communication skills.
- Organizational skills: Ability to manage multiple tasks, prioritize workloads, and meet deadlines.
- Customer service: Ability to interact professionally with members and internal and external stakeholders.
- Attention to detail: Ability to maintain accurate records and ensure regulatory compliance.
- Teamwork: Ability to collaborate effectively while also working independently.
Preferred Skills- Previous experience in health insurance, Medi-Cal, or healthcare administration.
- Understanding of managed care, Health Maintenance Organizations (HMO), and healthcare enrollment processes.
- Familiarity with healthcare regulations and agencies such as DHCS and DMHC.
- Experience with eligibility verification, enrollment reconciliation, and member data management.
- Previous customer service or member support experience.
- Bilingual proficiency in English and another recognized threshold language, such as Spanish, Vietnamese, Chinese, Korean, Arabic, Farsi, or Russian.
- Experience with Microsoft Access and database management is beneficial.
Education- High school diploma or equivalent is required.
- Minimum of one year of experience in eligibility processing and/or reconciliation.
- An equivalent combination of education and relevant work experience may also qualify.
Company Description 22nd Century Technologies, Inc. (TSCTI) is one of the fastest-growing IT Services Integrators and Workforce Solutions providers in the United States. Founded in 1997, TSCTI is a Certified National Minority Business Enterprise (MBE) with a workforce of 6,000+ professionals, including 600+ Cybersecurity Subject Matter Experts (SMEs), delivering mission-critical solutions across all 50 U.S. states, Canada, and Mexico.
Headquartered in Princeton, NJ, and McLean, VA, with 14 regional offices nationwide, TSCTI provides comprehensive solutions in Digital Transformation, Artificial Intelligence (AI), Cybersecurity, Cloud Computing, IT Infrastructure, Enterprise Modernization, DevSecOps, Managed Services, Workforce Solutions, and Healthcare Staffing. We are a trusted partner to Federal, State, Local, Education (SLED), Healthcare, and Commercial organizations, delivering innovative technology and talent solutions that enable our clients to achieve their strategic objectives.
As one of the nation's leading Healthcare Workforce Solutions providers, TSCTI supports federal healthcare systems, Veterans Affairs (VA) Medical Centers, state and local healthcare agencies, hospitals, clinics, laboratories, long-term care facilities, and commercial healthcare organizations. We recruit and place highly qualified healthcare professionals across a wide range of specialties, including physicians, advanced practice providers, registered nurses, allied health professionals, behavioral health specialists, laboratory personnel, pharmacy professionals, and healthcare administrative staff. Our healthcare solutions ensure continuity of care while maintaining the highest standards of clinical excellence and regulatory compliance.
With a strong commitment to quality and compliance, TSCTI operates through CMMI Level 3 (Development & Services) and ISO 9001, ISO 20000, and ISO 27001 certified processes, ensuring consistent service excellence, operational maturity, and information security. Today, we proudly support 14 of the 15 Federal Executive Departments, 37 Federal agencies, 50 State governments, 115+ Local agencies, 37 School Districts, numerous healthcare organizations, and 80+ Fortune 500 and commercial clients.
TSCTI has earned numerous industry recognitions, including being named among Forbes America's Best Large Employers, Forbes Best Employers for Veterans, Forbes Best Employers for Tech Workers, Newsweek's America's Greatest Workplaces for Diversity, and a 13-time Inc. 5000 honoree. The company has also been recognized by the Washington Business Journal as one of the Best Places to Work and continues to expand its capabilities through strategic innovation, acquisitions, and investments in emerging technologies.
At TSCTI, our people are our greatest strength. We are committed to fostering an inclusive, collaborative, and growth-oriented workplace where innovation thrives and careers flourish. Whether delivering cutting-edge technology solutions or connecting exceptional talent with meaningful careers, we consistently exceed our clients' expectations while empowering our employees to succeed.
Equal Opportunity Employer
22nd Century Technologies, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Company Description 22nd Century Technologies, Inc. (TSCTI) is one of the fastest-growing IT Services Integrators and Workforce Solutions providers in the United States. Founded in 1997, TSCTI is a Certified National Minority Business Enterprise (MBE) with a workforce of 6,000+ professionals, including 600+ Cybersecurity Subject Matter Experts (SMEs), delivering mission-critical solutions across all 50 U.S. states, Canada, and Mexico. Headquartered in Princeton, NJ, and McLean, VA, with 14 regional offices nationwide, TSCTI provides comprehensive solutions in Digital Transformation, Artificial Intelligence (AI), Cybersecurity, Cloud Computing, IT Infrastructure, Enterprise Modernization, DevSecOps, Managed Services, Workforce Solutions, and Healthcare Staffing. We are a trusted partner to Federal, State, Local, Education (SLED), Healthcare, and Commercial organizations, delivering innovative technology and talent solutions that enable our clients to achieve their strategic objectives. As one of the nation's leading Healthcare Workforce Solutions providers, TSCTI supports federal healthcare systems, Veterans Affairs (VA) Medical Centers, state and local healthcare agencies, hospitals, clinics, laboratories, long-term care facilities, and commercial healthcare organizations. We recruit and place highly qualified healthcare professionals across a wide range of specialties, including physicians, advanced practice providers, registered nurses, allied health professionals, behavioral health specialists, laboratory personnel, pharmacy professionals, and healthcare administrative staff. Our healthcare solutions ensure continuity of care while maintaining the highest standards of clinical excellence and regulatory compliance. With a strong commitment to quality and compliance, TSCTI operates through CMMI Level 3 (Development & Services) and ISO 9001, ISO 20000, and ISO 27001 certified processes, ensuring consistent service excellence, operational maturity, and information security. Today, we proudly support 14 of the 15 Federal Executive Departments, 37 Federal agencies, 50 State governments, 115+ Local agencies, 37 School Districts, numerous healthcare organizations, and 80+ Fortune 500 and commercial clients. TSCTI has earned numerous industry recognitions, including being named among Forbes America's Best Large Employers, Forbes Best Employers for Veterans, Forbes Best Employers for Tech Workers, Newsweek's America's Greatest Workplaces for Diversity, and a 13-time Inc. 5000 honoree . click apply for full job details
