- Sedgwick (Orange, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Assistant | Orange, CA (In-Office) Are you looking for an impactful job ... from some of the world's most reputable brands + An assigned mentor and manager who will guide you on your career journey + Career development and promotional… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all ... This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized… more
- LA Care Health Plan (Los Angeles, CA)
- Community Health Program Manager II (ALD) Job Category: Administrative, HR, Business Professionals Department: Community Health Location: Los Angeles, CA, ... required to achieve that purpose. Job Summary The Community Health Program Manager II is responsible for...include analysis of housing data on enrollment, payment, or claims data to identify operational problems or issues. Make… more
- Towne Park (Santa Monica, CA)
- …(http://www.townepark.com/wp-content/uploads/2023/06/CCPA-CPRA-Notice-at-Collection-Applicants\_Towne-Park-Careers.pdf) . The Account Manager directly oversees one ... may be subject to a specific plan or program terms. **JOB SUMMARY** The Account Manager directly oversees one Tier 1 or 2 Towne Park account and is responsible for… more
- Elevance Health (Walnut Creek, CA)
- **Title:** Behavioral Health Provider Quality Manager **Candidates must posses a licensure for the state of California.** **Location:** This role enables ... leaders passionate about transforming American healthcare delivery. The **Provider Quality Manager ** is responsible for leading Behavioral Health (BH) provider… more
- Molina Healthcare (San Diego, CA)
- …Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, or equivalent combination of relevant education and experience. + At ... subject matter expertise and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role executes and… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by...net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible… more
- 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 ... of the Director. **Required Qualifications** + 5 Years in HMO or Health Insurance Management. + 2 Years leadership experience working collaboratively across multiple… more
- Dignity Health (Bakersfield, CA)
- …to accomodate PST business hours.** **Position Summary:** The Senior Program Manager of Operational Automation will lead the design, implementation, and optimization ... deep familiarity with the complexities of delegated services, including claims , utilization management, provider data, and network operations. Essential Functions… more
- The County of Los Angeles (Los Angeles, CA)
- MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be… more