- Molina Healthcare (San Diego, CA)
- …issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, or...and claims payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of five ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with CMS processes...knowledge of the health care model, capitation and other managed care IPA and provider reimbursement methodologies. + Strong… more
- LA Care Health Plan (Los Angeles, CA)
- …agency requirements (Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS)) ... and braille projects in a language service provider setting or its equivalent. Managed care/health care experience including working in a health plan and/or with… more
- Ventura County (Ventura, CA)
- …as well as regulations and Health and Safety code for VCHCP, a Department of Managed Health Care (DMHC) licensed Commercial HMO. This position is part of a team of ... and techniques of diagnosis and treatment + Experience with managed care + Experience and current knowledge of Quality...of Medicine and includes the following: + Experience with managed care + Experience and current knowledge of Quality… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of five ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with CMS processes...knowledge of the health care model, capitation and other managed care IPA and provider reimbursement methodologies. + Strong… more
- Deloitte (San Diego, CA)
- …and business leaders for complex information technology (IT) operate and managed services contracts by executing careful review of contractual documents (and ... Management as follows: + Review and analyze IT operations and managed services contracts to identify and document business-relevant contractual obligations and… more
- Ensono (Los Angeles, CA)
- …that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep ... + 10-15 years of enterprise sales or account growth experience, within managed services or IT solutions + Demonstrated success in consultative, solution-based… more
- Highmark Health (Sacramento, CA)
- …and state rules as well as a solid working knowledge of managed care operations, compliance program structures, information security and audit methodologies. The ... partner and advisor to business leaders to ensure business decisions are managed according to the enterprise risk strategy / framework.Participates in and… more
- Evertz Microsystems Limited (Burbank, CA)
- …Singapore, and Australia. Evertz was named one of Canada's 50 Best Managed Companies, which recognizes excellence in Canadian-owned and Canadian- managed ... companies. Canada's 50 Best Managed Companies identifies Canadian corporate success through companies focused on their core vision, creating stakeholder value and excelling in the global economy. Evertz makes certain there is an equal employment… more
- Humana (Sacramento, CA)
- …such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or ... in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more