- 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
- Sharp HealthCare (San Diego, CA)
- …Nursing, and/or Home Health + 3 Years Medical Management experience, preferably in managed care , with supervisory experience + 2 Years Medical Management ... experience, preferably in a managed care setting + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred Qualifications** +… more
- Humana (Sacramento, CA)
- …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree Experience Required: At least 6 years of experience in financial auditing in a managed care industry. At least 4 years of leading, supervising and/ or ... verbal and written communication, and presentation skills. Knowledge of relevant managed care regulations and audit methodologies. Excellent analytical and… more
- LA Care Health Plan (Los Angeles, CA)
- …recording, and braille projects in a language service provider setting or its equivalent. Managed care /health care experience including working in a health ... management system, translation memory, machine/AI translation, etc.). Knowledge of managed care language assistance regulations. Licenses/Certifications Required… more
- LA Care Health Plan (Los Angeles, CA)
- …topics. Preferred: At least 4 years of experience in Program Management within a Managed Care Organization or Top 10 management consulting role in Healthcare ... industry. Strong experience in Medicaid and Medicare managed care . Skills Required: Demonstrated success managing programs with multiple, large scale, diverse… more
- Robert Half Office Team (Palm Springs, CA)
- …credentialing and recredentialing process for healthcare providers participating in managed care networks. Verify licenses, certifications, education, training, ... (CMS), The Joint Commission (TJC), and California-specific guidelines. Knowledge of Managed Care Requirements: Maintain up-to-date understanding of managed… more
- Molina Healthcare (California City, CA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- LA Care Health Plan (Los Angeles, CA)
- …gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines. The Customer Solution Center Service Representative ... with ability to type a minimum of 40 words per minute. Preferred: Managed care or health plan experience. Skills Required: Ability to answer a high volume… more