• Customer Solution Center Appeals and Grievances…

    LA Care Health Plan (Los Angeles, CA)
    …Education Preferred Experience Required: At least 6 months of experience in Medi-Cal managed care authorization processes and/or as a Medical Assistant. Skills ... Range: $47,840.00 (Min.) - $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of… more
    LA Care Health Plan (09/02/25)
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  • Value Based Provider Cost of Care

    Elevance Health (Cerritos, CA)
    …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Value Based Provider Cost of Care Consultant - Forecasting and Program Performance /...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/06/25)
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  • Case Management Coordinator (Hybrid) - MNS…

    Cedars-Sinai (Beverly Hills, CA)
    …and social supports required. + 1 year of previous utilization management or managed care experience; word processing spreadsheet skills also preferred. **Req ... Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's Workplace of… more
    Cedars-Sinai (07/18/25)
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  • Director, Care Management (RN/SW)

    Sutter Health (Modesto, CA)
    …knowledge base of health care delivery and case management within a managed care environment required. + Comprehensive knowledge of local, state and federal ... **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** Responsible for care coordination operations for Sutter Health. Works closely with… more
    Sutter Health (08/02/25)
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  • Sr. Design Architect

    Stanford Health Care (Menlo Park, CA)
    …discovered. Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** Located in the heart of Silicon Valley, Stanford Health Care 's (SHC) ... with the goal of enhancing the delivery of patient care . The Senior Design Architect will be a strategic,...to join our mission. **A Brief Overview** The Senior Manager Project Management is responsible for supervising staff to… more
    Stanford Health Care (08/13/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …Experience working in a cross functional work environment. Preferred: Experience in Medi-Cal managed care . 1 year of experience in UM/Prior Authorization. Skills ... $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
    LA Care Health Plan (08/29/25)
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  • Pharma Field Sales - Diabetes Care

    Novo Nordisk (San Mateo, CA)
    …in order to influence formulary status, as applicable + May analyze impact of managed care in the territory and its effect on prescribing decisions, and ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...partners. Internally, the DCS reports to the District Business Manager of the specific sales territory. The DCS also… more
    Novo Nordisk (08/22/25)
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  • Medical Director - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …clinical practice of medicine. + Previous experience as a physician executive in a managed care environment, preferably as an HMO Medical Director. + California ... a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists… more
    Sharp HealthCare (08/17/25)
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  • Compliance Specialist - MSO - CHOC MSO

    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 ... changes, legislative efforts, and /or industry trends specific to Managed Care operations and keeps Management Team...remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool… more
    Rady Children's Hospital San Diego (08/28/25)
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  • Team Lead Collections

    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 ... EIS to open tickets to load, fix and test managed care contracts. + Performs payer discrepancies...lead role in the absence of the Supervisor or Manager . Assist in the training of staff on Cedars-Sinai… more
    Cedars-Sinai (07/30/25)
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