- Cedars-Sinai (Los Angeles, CA)
- …with the department Senior Vice President and department directors, the Managed Care Coordinator supports the strategic, operational, and administrative ... functions of the Managed Care and Payer Relations department. Supports critical initiatives, contract implementation, credentialing, payer relations, and… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** Job Summary The Director of Managed Care develops and implements managed care and payer relations strategies including contract ... industry groups (eg, CHA, HASC, APG) to shape and align Cedars-Sinai's managed care strategy. **Qualifications** Education: + **Bachelor's Degree Required** -… more
- Cedars-Sinai (Beverly Hills, CA)
- …implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Managed Care Reporting: + Prepare reports and ... metrics, identifying trends, variances, and areas for improvement. + Analyze managed care contracts for compliance and financial performance, identifying… more
- Gilead Sciences, Inc. (Foster City, CA)
- …take the lead in managing Gilead's day-to-day administration and processing of all Managed Care Commercial/Medicare Part D contract payments, in support of the ... contract development activities of the Managed Markets Strategy & Operations group. This group is...managing and supporting Gilead's strategies with national and regional Managed Markets accounts in order to provide appropriate patient… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …HMO, Medi-Cal/Medicare and health services. Knowledge of principles and practices of health care service delivery and managed care , Medi-Cal eligibility and ... The PCC will identify and reduce barriers to members' care , assist the member in locating and accessing resources,...and educate the member on the importance of accessing care promptly. The PCC will serve as the primary… more
- Molina Healthcare (Long Beach, CA)
- …Must have intermediate level MS Excel experience, + Familiarity with Enrollment and Managed Healthcare experience is required. + Must be able to research and analyze ... data using SQL is required. + Experience with QNXT is preferred. + Medicare/ medicaid membership exp required Required soft skill include but are not limited to : + Excellent communication + Possess a team player attitude + Ability to work in a diverse… more
- Molina Healthcare (Long Beach, CA)
- …Must have intermediate level MS Excel experience, + Familiarity with Enrollment and Managed Healthcare experience is required. + Must be able to research and analyze ... data using SQL is required. + Experience with QNXT is preferred. + Medicare/ medicaid membership exp required Required soft skill include but are not limited to : + Excellent communication + Possess a team player attitude + Ability to work in a diverse… more
- LA Care Health Plan (Los Angeles, CA)
- …and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience ... with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed ...as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services,… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Bachelor's Degree Experience Required: At least 2 years of experience in Managed Care with specific experience in resolving member and provider ... interpret and apply regulations. At least 5 years of experience in Managed Care working with Medicare, Medi-Cal and other State Sponsored programs. Knowledge of… more
- Ventura County (Ventura, CA)
- …the current principles and techniques of diagnosis and treatment + Experience with managed care + Experience and current knowledge of Quality Assurance, ... Doctor of Medicine and includes the following: + Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review… more