- Magellan Health Services (San Diego, CA)
- …team approach, including all participants of the Interdisciplinary Care Plan team, Health Plan Medical Care Management where appropriate, to ensure ... implement solutions that directly influence quality of care. Understanding of plan benefit structures, psychiatric/medical terminology, call center terminology… more
- Deloitte (Los Angeles, CA)
- …payors, pharmacies and patients. + Prepare self-insured financial projections and support health plan management , including financial reporting, premium rate ... Pharmacy Benefit Manager/ Health & Group Benefits...content. + Demonstrated knowledge of at least three US health & welfare benefit plan ...at least three US health & welfare benefit plan types (such as life, disability,… more
- University of Southern California (Los Angeles, CA)
- …in supporting USC through key initiatives through health plan management , plan design, benefit planning, employee contribution pricing, financing and ... plan administration, oversight of operations and strategy of wellness and medical management programs, manage health plan member services and in… more
- LA Care Health Plan (Los Angeles, CA)
- …experience working with a California Medi-Cal managed care plan or Commercial health plan , medical group, or management services organization. Skills ... (Mid.) - $151,034.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency...Configuration Assurance Analyst III collaborates closely with peers and management within the department as well as throughout the… more
- Deloitte (Fresno, CA)
- …21st, 2025. Work you'll do + Prepare self-insured financial projections and support health plan management , including financial reporting, premium rate ... contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against strategy. + Act as an extension of… more
- Elevance Health (Los Angeles, CA)
- …and participation in client meetings as requested. + Interface with Health Plan stakeholders, Pharmacy Benefits Management (PBM) leadership, and senior ... York, Washington State In addition to your salary, Elevance Health offers benefits such as, a comprehensive...agreement), medical, dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan , life… more
- Molina Healthcare (San Diego, CA)
- …Plans, organizes, staffs, and coordinates the Provider Services activities for the state health plan . Works with direct management , senior leadership/ ... establishing both internal and external long-term partnerships. * Works collaboratively with health plan network management and operations teams and… more
- Sharp HealthCare (San Diego, CA)
- …in overall medical management effectiveness. Reports all issues of clinical quality management to the health plan Chief Medical Officer. To ensure ... **Facility:** Health Plan **City** San Diego **Department**...other plan functions that interface with medical management such as provider relations, member services, benefits… more
- Sharp HealthCare (San Diego, CA)
- …in promoting the Mission, Goals and Objectives of Sharp Health Plan . Demonstrates content expertise regarding benefits administration and business operations ... activities. **Required Qualifications** + 3 Years in HMO or Health Insurance Management . + Experience working collaboratively...departments to better understand plan designs and benefit intent as directed.Assist with plans and benefits… more
- Sharp HealthCare (San Diego, CA)
- …background information for other departments to better understand plan designs and benefit intent. Manage all plans and benefits hand-offs to internal and ... individual will serve as a subject matter expert on benefits , with responsibility for translating plan designs...in promoting the Mission, Goals and Objectives of Sharp Health Plan .Recruit, hire, motivates staff to perform… more