- Cardinal Health (Sacramento, CA)
- **_What Managed Care contributes to Cardinal Health_** Practice Operations Management oversees the business and administrative operations of a medical practice. ... Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting,… more
- LA Care Health Plan (Los Angeles, CA)
- …agreements across all lines of business. The position is responsible for the Department of Managed Health Care (DMHC) claims data submissions for LA Care and ... financial audits. At least 5 years of related experience in the managed health care industry. Preferred: Health Care experience. Skills Required: Excellent… more
- LA Care Health Plan (Los Angeles, CA)
- …and maintaining .Net databases and software applications. Preferred: Experience on Managed Health- care Information systems, subsystems and applications. Skills ... handle multiple tasks simultaneously. Strong project management skills. Must understand Managed Health Care Information systems, subsystems and applications.… more
- Ventura County (Ventura, CA)
- …with the compliance office. Experienced in leading and training staff on Managed Care , Medicaid, Medi-Cal, Medicare, and Commercial Insurance, they ensure ... billing and supervises or conducts training on the specific areas of Managed Care /Medicaid/Medi-Cal/Medicare and/or Commercial Insurance; + Works with the… more
- Dignity Health (Bakersfield, CA)
- …lead the design, implementation, and optimization of enterprise-wide automation initiatives across managed care functional areas supported by the PHSO. This ... Develop and operationalize an automation roadmap aligned to PHSO managed care objectives, with focus areas including delegated operations, quality, analytics,… more
- CommonSpirit Health (Rancho Cordova, CA)
- …The Market Director, Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals and objectives related to contract language ... payer relationships, negotiations, organizational contractual obligations, and developments in the managed care marketplace including Fee For Service and… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …as an independent, the Compliance Specialist's primary function is to ensure the Managed Care business unit is meeting compliance with rules, policies, and ... regulatory changes, legislative efforts, and /or industry trends specific to Managed Care operations and keeps Management Team informed of relative changes. The… more
- LA Care Health Plan (Los Angeles, CA)
- … Covered) in a manner consistent with regulatory requirements from the Department of Managed Health Care , Department of Health Care Services, Centers for ... $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...members, we make sure our members get the right care at the right place at the right time.… more
- CommonSpirit Health (Rancho Cordova, CA)
- …system standards for contracting and payer relations. Accountabilities include: ensuring that managed care contracts are correctly negotiated and implemented for ... + As applicable, ensure standardized monthly, quarterly and ad-hoc meetings with Managed Care Organizations occur and issues are resolved in a timely fashion. +… more
- Dignity Health (Bakersfield, CA)
- …efforts related to claims overpayments, underpayments, and billing issues within a managed care service organization. This role involves review/ensuring accurate ... of experience in claims research, analysis, or a related role within a managed care or healthcare environment - Proven experience in a lead role, with strong… more
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