- 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
- Ventura County (Ventura, CA)
- …Type Full-Time Regular Job Number 0912CEO-25AA (MA) Department County Executive Office Opening Date 06/02/2025 + Description + Benefits + Questions Description ... 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
- 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...in Sacramento or Emeryville, CA. **Job Shift:** Days **Schedule:** Full Time **Days of the Week:** Monday… 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 ... Cultivate and maintain trusted relationships with CMOs and senior executive /clinical leaders at provider and care delivery...a good faith estimate of starting base pay for full time (40 hours per week) employment… more
- Humana (Sacramento, CA)
- …MPH, or other relevant advanced degree + Healthcare industry experience, particularly in managed care or provider sectors + Experience leading strategy projects ... other health plans to millions. By integrating insurance with care delivery through CenterWell, Humana is improving healthcare access,...a good faith estimate of starting base pay for full time (40 hours per week) employment… more
- Humana (Sacramento, CA)
- …first** The Formulary Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care , PBM, market and regulatory insights to develop, and/or ... line of business. + Utilizes broad understanding of pharmacy, managed care , PBM, market and regulatory insights...a good faith estimate of starting base pay for full time (40 hours per week) employment… more
- The County of Los Angeles (Los Angeles, CA)
- …Salary $65,911.68 - $88,823.04 Annually Location Los Angeles County, CA Job Type Full time Job Number Y0927E Department HEALTH SERVICES Opening Date 06/01/2022 ... by Consolidated Accreditation and Licensure Survey and Office of Managed Care as requested; conducts internal reviews;...REQUIREMENTS: TRAINING AND EXPERIENCE: Three (3) years of recent*, full time ** experience in a Medical Staff… more
- Humana (Sacramento, CA)
- … care management, or provider performance improvement. + 5+ years experience in managed care industry, either provider or payer. + Strong understanding of ... coordinating with cross-functional teams to drive quality, utilization, and cost-of- care outcomes. At the core, this is a role...a good faith estimate of starting base pay for full time (40 hours per week) employment… more
- Sutter Health (Los Altos, CA)
- …consistency across different locations. **Knowledge:** + Thorough understanding of the California managed care and health care industries including the ... Silicon Valley (GSV) Division is seeking an experienced operations executive to spearhead the expansion of an important part...in the Silicon Valley Division._ **Job Shift:** Days **Schedule:** Full Time **Days of the Week:** Monday… more