- Evolent (Sacramento, CA)
- …member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- The County of Los Angeles (Los Angeles, CA)
- …over 5,120 contracted workers of varying professions in facilities management , information technology, environmental, administrative, purchasing and contracting, ISD ... their solution, and implements approved recommendations. Advises top departmental management on problems, makes recommendations for their solution, and implements… more
- Robert Half Legal (San Francisco, CA)
- …with paralegals and legal assistants to ensure timely and organized case management . + Assist with litigation preparation as needed, including drafting pleadings and ... coordinating with experts and investigators. + Advise on claims handling and negotiation strategies with insurance carriers. Requirements Qualifications + Licensed… more
- CVS Health (Sacramento, CA)
- …challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker ... relations, underwriting, eligibility, finance, client management and much more. Develop and hone your skills...Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with… more
- Stanford University (Stanford, CA)
- …plays a key role in administering benefits programs, including oversight and management of vendors and consultants, and as an internal resource for employees. ... cost and performance, and ensure accurate and timely plan administration, claims payment, manage escalated issues, etc. + Manage monthly billings, enrollments,… more
- AON (San Francisco, CA)
- …Skills and Experience Preferred: + Commercial insurance experience (eg underwriting, broking, claims , or a support role). + Familiarity with mergers & acquisitions, ... with local Fair Chance ordinances. Nothing in this job description restricts management 's right to assign or reassign duties and responsibilities to this job… more
- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that the care provided to ... steps to view correspondence, and we will not consider claims for missing notices to be a valid reason...Utilization Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that… more
- University of Southern California (Los Angeles, CA)
- …lead programmer and technical specialist on research projects that use administrative healthcare claims data. SAS is required. The programmer is an integral part of ... projects. + Experience with health data, including large administrative healthcare claims data from Medicare or private health insurance plans. Experience with… more
- Sedgwick (Long Beach, CA)
- …staffing activities within a designated region and partners with Operational management to implement timely, cost-effective initiatives aligned with regional and ... not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the… more
- Kyndryl (Sacramento, CA)
- …Electronic Medical Record, Imaging, Medical Device Integrations, Contact Centers, Claims , Provider, Sales, cloud-based solutions), emerging technologies (eg, AI/ML, ... Medical Record, Imaging, Medical Device Integrations, Contact Centers, Payer, Claims , Provider cloud-based solutions, or custom cloud applications. + Demonstrated… more