- Sharp HealthCare (San Diego, CA)
- …5 years' experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review. + California Physicians and ... **Essential Functions** + Customer serviceProvides prompt, accurate, and excellent services to internal and external customers.Develops solid professional working… more
- Lincoln Financial (Sacramento, CA)
- …responsibility. + Manages and monitors working relationships with third-party vendors and managed service providers + Assists with developing more complex ... providers. + Support strategic asset realignment across General Account portfolios on service provider managed accounting systems and across multiple custodians.… more
- Humana (Sacramento, CA)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or clinical ... in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + Experience with national guidelines,… more
- Valor Health (Gardena, CA)
- …the US Department of Veterans Affairs. Valor provides a full range of medical services to veterans through the operations of CBOCs, tailored to meet the specific ... needs of local VA medical centers. Our comprehensive set of services includes primary care, diagnostics, laboratory, telehealth, behavioral health, and more. Valor… more
- Molina Healthcare (San Francisco, CA)
- …in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years experience in ... provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract...including but not limited to: Value Based Payment, fee-for service , capitation and various forms of risk, ASO, etc.… more
- BlackRock (Sausalito, CA)
- …across direct indexing, fixed income, active equity, and multi-asset. We deliver world-class service to all our clients, from wealth advisors to family offices to ... QIS is responsible for driving strategic product innovation, developing tax- managed investment strategies, and advancing quantitative research. The team spearheads… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of five ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with CMS processes...travel/attend off-site meetings and conferences. + Must be customer service oriented, be able to work well individually and… more
- UCLA Health (Los Angeles, CA)
- …field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum of five ... years' experience with CMS processes in a Medicare or Managed Care environment required + Experience with CMS processes...analytical and problem solving abilities + Must be customer service oriented, be able to work well individually and… more
- Deloitte (Fresno, CA)
- Deloitte's Enterprise Operations as a Service provides multi-year managed service contracts to support enterprise technology investments and key business ... effective forum for sharing SAP expertise The team Our managed services focuses on on-going operations and...maintenance + Adoption of leading automation technologies to improve service delivery and efficiency + Better cost efficiency and… more
- LA Care Health Plan (Los Angeles, CA)
- …with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services , ... and technical assistance to ECM Providers to support effective delivery of ECM services and ensure compliance with local, State, and Federal regulations, statues and… more