• Psychiatrist

    Valor Health (Gardena, CA)
    …VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Conducts individual, group, and family and marriage counseling and/or ... reminders "due" at the time of each patient visit. + Assists in co- managed care collaboration with non-VA providers, and facilities. + Functions as case manager… more
    Valor Health (06/10/25)
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  • Call Center Representative - Patient Engagement…

    Providence (Mission Viejo, CA)
    …departments by advocating on behalf of members, and helps them navigate through the managed care system. This position is responsible for the resolution of ... in a Healthcare setting. + Customer service experience in a managed care environment. + IDX experience. **Why Join Providence?** Our best-in-class benefits… more
    Providence (08/27/25)
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  • Provider Relations Representative

    Providence (Anaheim, CA)
    …for additional information. + 1 year of experience working with physicians in a managed care /IPA, Medical group, health plan or MSO environment with Provider ... + Bachelor's Degree in Healthcare Management. + 2 years of Managed care Provider Relations experience. **Why Join Providence?** Our best-in-class benefits are… more
    Providence (08/27/25)
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  • Vice President, Growth - Payer

    Evolent (Sacramento, CA)
    …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... long cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers and risk-bearing organizations) + Passion… more
    Evolent (06/16/25)
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  • Manager Network Strategy and Contracting

    Dignity Health (Bakersfield, CA)
    …- Masters degree preferred. - 5 years experience with background in a managed care facility, IPA or health plan preferred. **Overview** The purpose ... management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health… more
    Dignity Health (07/31/25)
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  • Medical Director -Pharmacy Appeals

    Humana (Sacramento, CA)
    …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... and other responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The Medical Director will… more
    Humana (08/22/25)
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  • Sr. Specialist-Pharmacy Contracts - Sharp System…

    Sharp HealthCare (San Diego, CA)
    …the system. **Required Qualifications** + 3 Years experience in a hospital, ambulatory care and/or managed care pharmacy environment. + California Pharmacist ... of Pharmacy -REQUIRED **Preferred Qualifications** + 3 Years experience with managed care , PBM and/or Medicare Part D, Medicaid, Commercial Health Insurance. +… more
    Sharp HealthCare (07/27/25)
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  • Director Provider Contracting

    Dignity Health (Bakersfield, CA)
    …Minimum of eight (8) years of progressive experience in provider contracting, payer negotiations, managed care strategy - At least five (5) years in a leadership ... management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health… more
    Dignity Health (07/24/25)
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  • Physician Reviewer - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …years' experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review. + California ... and Abilities** + Knowledge of physician social and political behavior and managed care philosophy. + Demonstrate effective communication skills, ability to… more
    Sharp HealthCare (08/27/25)
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  • Assistant Director Behavioral Health

    Ventura County (Ventura, CA)
    …through division managers, a comprehensive system of integrated behavioral health services, managed care operations and administrative services; + Assists the ... best practices of behavioral health program planning and administration including managed care operations; recruitment, supervision and personnel management;… more
    Ventura County (08/27/25)
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