Teams at Community Health Group

Perform community outreach and education about Medicare and Medi-Cal managed care; enroll eligible individuals into plans; conduct presentations, provider surveys, and health fair participation; collaborate with internal teams and attend trainings to ensure compliance with federal and state regulations.

Supervise case management activities to resolve Medicare member concerns, coordinate care and services (including home visits), document interactions, meet phone benchmarks, refer grievances, assist with transfers and billing issues, and partner with community organizations to address members' medical and social needs.

Maintain and audit provider data and delegate oversight across Symplr and QNXT systems. Produce and update provider directories, generate daily audits, ensure regulatory compliance (DHCS, DMHC, CMS), coordinate across departments, and support reporting and process improvements.