- LA Care Health Plan (Los Angeles, CA)
- …etc. Collaborates with internal departments (Member Services, Provider Network Operations, Claims , Utilization Management , Pharmacy, and Quality Management ) ... quality of care issues and work collaboratively with multiple departments ( Claims , Provider Network Operations, Utilization Management , Quality Management… more
- Adecco US, Inc. (Vallejo, CA)
- …union leadership-in continuous ESG improvement initiatives. **Workers' Compensation & Claims Management ** + Administer workers' compensation program: incident ... to expand the team as the business grows. **Responsibilities:** **People Management & Team Leadership** + Provide day-to-day supervision, coaching, and performance… more
- Dignity Health (Bakersfield, CA)
- …and deep familiarity with the complexities of delegated services, including claims , utilization management , provider data, and network operations. Essential ... including needs assessment, business case development, stakeholder alignment, risk management , and sustainment planning. - EZCAP Automation Development: Collaborate… more
- The Cigna Group (Los Angeles, CA)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical Economics, Compliance, ... in the Glendale/Los Angeles, CA area.** The **Manager, Provider Contracting Network Management ** serves as an integral member of the Provider Contracting Team and… more
- Cedars-Sinai (Los Angeles, CA)
- …solution definition, applications development and maintenance and enhancements for finance, claims processing, revenue management , and billing systems. Primary ... alignment on revenue cycle initiatives. + Monitor and analyze claims data sent to the clearinghouse, including resolution of...ensure accuracy and compliance. + Manage specific Payer Revenue Management (PRM) Claim Edit work queues (WQs) and WQ… more
- Dignity Health (Bakersfield, CA)
- …all necessary areas that collaborate with the contracting department (ie, Claims , Utilization Management /Authorizations, Benefits, and Finance) to provide ... structures for operational clarity. - Collaborate with market leadership, finance, claims , and network teams to align contracting strategy with growth objectives.… more
- HUB International (Newport Beach, CA)
- …professionals play a vital role in supporting our clients with day-to-day account management , claims management , and underwriting services that ensure they ... maintains strong carrier relationships, and understands client needs. + Manages claims and coverage issue resolution for clients' employees when elevated from… more
- HUB International (Encino, CA)
- …professionals play a vital role in supporting our clients with day-to-day account management , claims management , and underwriting services that ensure they ... maintains strong carrier relationships, and understands client needs. + Manages claims and coverage issue resolution for clients' employees when elevated from… more
- Robert Half Finance & Accounting (San Ramon, CA)
- …employees in a timely fashion. * Oversee Worker's Compensation to include claims management ; reporting, follow up with employees/claim rep/nurse case manager ... and bi-weekly non-union payroll for approx. 120 employees. * Work closely with management to ensure payroll compliance; ie: verifying hours, OT, vacation and sick… more
- Travelers Insurance Company (Irvine, CA)
- …of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. + Claim management experience preferred. **What is ... Is the Opportunity?** Under general direction and as a member of the local management team, this position is responsible for product quality and performance of the… more