- 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 ... Manager, Customer Solution Center Appeals and Grievances Job Category: Management/ Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017… more
- Alameda Health System (Oakland, CA)
- …of the project. 7. Performs other duties as assigned by the Interagency Executive Committee and the Managed Care Coordinator. **MINIMUM QUALIFICATIONS:** ... Chief Information Officer + Oakland, CA + Executive + Hospital Administration + Full Time -...providers and state and local eligibility systems to the Managed Care Information System. 4. Manage the… 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, ... regarding delegated utilization management and disease management operations under managed care contracts. You will meet all regulatory/contractual/accreditation… more
- HealthTrust Workforce Solutions (Campbell, CA)
- …of ten years of progressively responsible executive management experience in a Managed Care environment with at least five years in a significant general ... measures are taken to correct unsatisfactory results. 14. Ensures compliance of managed care operations with all laws, regulations, rulings, ordinances and… 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, ... Quality. The role will also work closely with the Executive Team, who serve as Executive Sponsors...with a business objective to excel in coordinating patient care in a manner that supports containing costs while… more
- Ventura County (Ventura, CA)
- …CA Job Type Full-Time Regular Job Number 0912CEO-25AA (MA) Department County Executive Office Opening Date 06/02/2025 + Description + Benefits + Questions ... Increase your spending power by reimbursement with pre-taxed dollars for IRS-approved dependent care and health care expenses. + Holidays: 12 paid days per… more
- Molina Healthcare (Long Beach, CA)
- …* 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding. * Independently delivers training and presentations to… more
- Sutter Health (Sacramento, CA)
- …Knowledge of accounting, healthcare reimbursement, financial forecasting, operations analysis, managed care contracting, capitation management, general finance, ... million patients through a network of hospitals, clinics, and care services. With a legacy of more than 100...The VP, Chief Accounting Officer, will be the top executive at Sutter Health responsible for the system-wide and… more
- Humana (Sacramento, CA)
- …training and certification + 5+ years clinical practice + 5 + years in managed care industry, either provider or payer. + Thorough knowledge of health ... Strategy: + Cultivate and maintain trusted relationships with CMOs and senior executive /clinical leaders at provider and care delivery partner organizations.… more
- Evolent (Sacramento, CA)
- …is differentiated through content knowledge and proficiency + Personally initiate and foster executive level relationships at managed care organizations or ... facing role, this person must exude an energetic, strong executive presence and have a mission driven mentality to...cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers… more