- Humana (Sacramento, CA)
- …and certification + 5+ years clinical practice + 5 + years in managed care industry, either provider or payer . + Thorough knowledge of health care ... trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this is a role focused… more
- HCA Healthcare (Riverside, CA)
- …You will provide medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... provider relations in contracting issues +...regarding delegated utilization management and disease management operations under managed care contracts. You will meet all… more
- 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 ... Pharmacy -REQUIRED **Preferred Qualifications** + 3 Years experience with managed care , PBM and/or Medicare Part D,...to drug reimbursement and net revenue, across all ambulatory care settings.Assists Contract's team with DOFR contracting … more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, ... robust, community based integrated delivery networks that ensure excellent, comprehensive care with the strategy of national growth. This position is responsible… more
- Evolent (Sacramento, CA)
- …discussions . Experience building and developing team members . Knowledge of the managed care and oncology market trends (both payers and risk-bearing ... organizations) . Passion for healthcare and subscribed to the vision of value-based care . Strong familiarity with risk-based contracting . Thrives in an… more
- Evolent (Sacramento, CA)
- …least 5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care , or related healthcare consulting ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Elevance Health (Walnut Creek, CA)
- …+ Travels to the worksite and other locations as necessary preferred. + Managed care experience preferred. For candidates working in person or virtually ... Health family of brands, offering clinical programs and primary care options for seniors. We are a team of...via Web-Ex to support provider training on Carelon processes, contracting / credentialing and linkages for issue resolution, helping… more