• Vice President of Health Plan

    Prime Healthcare (Ontario, CA)
    …team! Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for ... across all aspects of the Employee Health Plans. The VP of Health Plan Operations and Claims will provide strategic leadership and development of the… more
    Prime Healthcare (12/24/25)
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  • Director of IT Sharp Health Plan

    Sharp HealthCare (San Diego, CA)
    plan initiatives. Co-chairs SHP-ISD Governance Committees, as appropriate with health plan operations leaders.Communicates project status, targets, ... in the support of health plan information systems that enhance health plan business operations and that further the system integration of the Sharp… more
    Sharp HealthCare (12/28/25)
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  • Customer Strategy Consultant

    Highmark Health (Sacramento, CA)
    …sales narratives and messaging for our products, networks, reimbursement, clinical services, UM, and health plan operations in a powerful and compelling way ... RESPONSIBILITIES** + Collaborate with matrixed partners to define and refine Highmark Health Plan 's sales narratives in a compelling way that establishes… more
    Highmark Health (11/21/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Sacramento, CA)
    …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
    Highmark Health (10/29/25)
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  • Senior Business Consultant

    CVS Health (Sacramento, CA)
    … insurance experience preferred). + Experience in business consulting, customer experience or health plan operations . + Ability to synthesize information ... At CVS Health , we're building a world of health...synthesis of customer feedback across multiple sources, such as plan sponsors, members, sales and service teams, brokers and… more
    CVS Health (12/24/25)
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  • Senior Program Manager, Supplemental Benefits…

    UCLA Health (Los Angeles, CA)
    …degree, preferred + Eight or more years in managed care, Medicare Advantage, or health plan operations , including vendor and supplemental benefit management ... the vendor lifecycle + Partner cross-functionally with internal teams (eg, Operations , Compliance, Finance, Product, and Clinical) to ensure accurate benefit… more
    UCLA Health (12/23/25)
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  • Systems Analyst-EDI Management - SHP Finance…

    Sharp HealthCare (San Diego, CA)
    …acknowledgements. **Knowledge, Skills, and Abilities** + Demonstration of professional level of knowledge of health plan operations , health plan ... standards and system configuration. + Working knowledge of hospital, physician and health plan operations . + Strong analytical and problem solving skills;… more
    Sharp HealthCare (10/26/25)
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  • VP, Client Value

    Evolent (Sacramento, CA)
    …into actionable strategies. + **Industry Knowledge:** Deep understanding of value-based care, health plan operations , and provider partnerships. + ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health more
    Evolent (12/18/25)
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  • Manager of Revenue Integrity Compliance

    Prime Healthcare (Ontario, CA)
    …and state financial reporting regulations. + Collaborate with cross-functional teams including Health Plan Operations , Patient Access, Marketing, IT, and ... Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare...implement, and manage the Revenue Integrity & CDM Compliance Plan . + Ensure compliance with CMS Price Transparency Rule… more
    Prime Healthcare (11/25/25)
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  • Senior Experience Consultant

    Robert Half The Creative Group (Long Beach, CA)
    …workflows. This position is ideal for someone with a strong background in Medicare or health plan operations and a proven ability to lead structured ... and review sessions. Requirements * Extensive experience in Medicare, healthcare, or health plan workflows. * Strong proficiency in creating service blueprints… more
    Robert Half The Creative Group (12/20/25)
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