- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... Administration team members. Assumes additional responsibilities in the absence of the Director . **Required Qualifications** + 5 Years in HMO or Health Insurance… more
- Sharp HealthCare (San Diego, CA)
- …and refer requests for review by higher level staff (Medical Director , Hospitalist or HCM) within department turn around time (TAT) standards.Researches ... in the denial process - gathers documentation after review by medical director , ensure packet information is complete, assesses and select the appropriate denial… more
- Dignity Health (Bakersfield, CA)
- …**Position Summary:** The Manager, Network Strategy and Contracting reports to the Director of Provider Contracting. Key areas of oversight include negotiation of ... structures for operational clarity. - Collaborate with market leadership, finance, claims , and network teams to align contracting strategy with growth objectives.… more
- Stanford University (Stanford, CA)
- …as they develop their careers and enrich their lives. Reporting to the Global HR Director and in partnership with the Senior Director of Benefits, the Global ... cost and performance, and ensure accurate and timely plan administration, claims payment, manage escalated issues, etc. + Manage monthly billings, enrollments,… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director /Medical Director to research any issues (ie contract,… more
- Molina Healthcare (Riverside, CA)
- …and JOCs. Entail heavy negotiations. Maintains critical Complex provider information on claims and provider databases. Synchronizes data among multiple claims ... Operating Committees, and delegation oversight. * In conjunction with Director , Provider Contracts, develops health plan-specific provider contracting strategies… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director /Medical Director to research any issues (ie contract,… more
- Healthcare Services Group, Inc. (Sacramento, CA)
- …Job Type:Full-Time - Remote (20% Travel) Reports To: Human Resources Director Responsibilities Healthcare Services Group (HCSG) is currently seeking to fill ... join our growing Corporate Team! This position reports to the Human Resources Director . This role is primarily responsible for the investigation, and resolution of… more
- Stanford Health Care (Menlo Park, CA)
- …with the Stanford Integrated Master Plan. Stanford Health Care is seeking a Healthcare Director of Construction with 10 to 20 years of experience in managing large ... management of the $1.5B Renovation of the 300 Pasteur Drive Stanford Hospital. The Director will lead teams of 20+ to execute the work. This hybrid position requires… more
- San Jose State University (San Jose, CA)
- …employees, departments, and divisions. Key Responsibilities + Thoroughly investigate claims of protected status discrimination and harassment, sexual misconduct, ... IX and Equal Opportunity and/or Systemwide Senior Civil Rights Director , when requested. + Assist the Associate Vice President...upon request by contacting the Office of the Clery Director by phone at ### or by email at… more