- Dignity Health (Bakersfield, CA)
- … the design, implementation, and optimization of enterprise-wide automation initiatives across managed care functional areas supported by the PHSO. This ... Automation Strategy: Develop and operationalize an automation roadmap aligned to PHSO managed care objectives, with focus areas including delegated operations,… 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 ... Specialist IV ($ 27.86- $35.37 per hour) is the lead level class and serves as technical advisors to...supervises or conducts training on the specific areas of Managed Care /Medicaid/Medi-Cal/Medicare and/or Commercial Insurance; + Works… more
- Amgen (Los Angeles, CA)
- …2 years of public or private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Master's degree AND 4 years of ... will participate in strategic meetings at various levels and lead their team to success. + Lead ...private third-party access arena or pharmaceutical industry in sales, managed care , or clinical support OR Bachelor's… more
- Cedars-Sinai (Los Angeles, CA)
- …accounts to ensure payment and resolution. + Monitors, evaluates, and reviews Cedars-Sinai Managed Care contracts and reconcile to payments received. + Ensures ... you will be doing in this role:** The Team Lead oversees the Collections and Denials Management unit. Responsible...EIS to open tickets to load, fix and test managed care contracts. + Performs payer discrepancies… more
- Dignity Health (Bakersfield, CA)
- …for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves auditing claims, identifying ... processing, quality assurance, or a related role within a managed care or healthcare environment. + Strong...of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population… more
- HealthTrust Workforce Solutions (Campbell, CA)
- …measures are taken to correct unsatisfactory results. 14. Ensures compliance of managed care operations with all laws, regulations, rulings, ordinances and ... of ten years of progressively responsible executive management experience in a Managed Care environment with at least five years in a significant general… more
- HCA Healthcare (Campbell, CA)
- …and integrity. We care like family! Jump-start your career as a Managed Care Network Management Coordinator today with HCA Healthcare. **Benefits** HCA ... vary by location._** Come join our team as a Managed Care Network Management Coordinator. We ...experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent… more
- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... 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
- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
- Dignity Health (Bakersfield, CA)
- …more years of account management experience working with a medical group or IPA in a managed care environment. + 5 or more years' experience working in a similar ... authorization, claims administration and provider network administration. Familiarity with managed care and self-insurance products and benefits. **Preferred… more