- 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, ... Responsibilities** The Claims Recovery Manager is responsible for leading the recovery operations within the MSO Claims department. This role oversees all efforts to… more
- Humana (Sacramento, CA)
- …for the ongoing quality control, development, and delivery of IT products and services for their assigned state. + Partners with strategy advancement to drive ... experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid...5 + years in Medicaid program implementation or healthcare operations , with demonstrated leadership of complex, multi-disciplinary projects +… more
- Evertz Microsystems Limited (Burbank, CA)
- …In this role, you will report to the Senior Manager of the Technical Operations Centre and play a key part in supporting and maintaining complex, cutting-edge ... reviewing system and application logs. + Ensure events are managed until resolution while adhering to Incident and SLA...and solutions that deliver content to television sets, on-demand services , WebTV, IPTV, and mobile devices (like phones and… more
- Gilead Sciences, Inc. (Foster City, CA)
- …Value & Access IT operational needs - from onboarding new team members, overseeing managed services providers to owning the IT processes that support our ... and liaise with a broad team including Market Access Operations , US Commercial Legal, Internal Audit, IT Vendor Management,...competitive advantage for Gilead. + Ensure that projects are managed and monitored to ensure benefits are met and… more
- Ensono (Los Angeles, CA)
- …that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to ... COLLABORATION, CURIOSITY, PASSION** At Ensono, we are transforming into a software-first Managed Services Provider, powered by our Envision Operating System -… more
- The County of Los Angeles (Los Angeles, CA)
- … services and/or management oversight functions to staff and operations dedicated to supporting County end-user departments, vendors, and related agencies ... Job Type Full time Job Number W1078F-EA Department INTERNAL SERVICES Opening Date 09/03/2024 Closing Date Continuous + Description...examination will remain open until the needs of the service are met and is subject to closure without… more
- TEKsystems (Canoga Park, CA)
- …to ensure medical necessity, compliance, and timely processing within a managed care environment. Key Responsibilities + Perform comprehensive utilization reviews ... directors and provide clinical recommendations. + Ensure compliance with managed care authorization requirements and organizational policies. + Communicate… more
- TEKsystems (Canoga Park, CA)
- …necessity and compliance, ensuring timely and accurate processing in a managed care environment. Key Responsibilities: + Perform detailed utilization reviews for ... recommendations based on clinical review. + Ensure compliance with managed care authorization requirements and organizational policies. + Communicate effectively… more
- Highmark Health (Sacramento, CA)
- …efficiency strategies, contractual or programmatic changes, quality-of-care outcomes, customer service and other specific product related requirements. The incumbent ... as necessary. + Ensure that all contractual obligations including service level agreement (SLA) targets are achieved. + Ensure...Active pharmacist license + 4 years of experience in managed care pharmacy + 2 years of clinical account… more
- Compass Group, North America (San Diego, CA)
- … service mindset with proven experience managing complex, distributed operations . **Key Responsibilities** **Operational Leadership** + Direct operations ... inventory systems. + Willingness to travel regionally. **Preferred:** + Experience in contract- managed or route-based services . + Background in large-scale food,… more