- Prime Healthcare (Lynwood, CA)
- …seeking new members to join our corporate team! Responsibilities The Senior Managed Care Biller/Collector is responsible for both billing and collections, ... with the specific payer guidelines, policies, procedures, and compliance regulations for managed care . This includes maintaining the deficiency lists used to… more
- Dignity Health (Bakersfield, CA)
- …loading benefit information. Responsibilities may include: - Develop all hierarchy levels in managed care platform for customer setups and configuration - Review ... Policies and Procedures for the benefit workflow within the managed care platform - Support quality reviews...from a variety of options including medical dental and vision plans for the employee and their dependents Health… more
- Aston Carter (Los Angeles, CA)
- …evaluate contract changes and new reimbursement models. Your role involves analyzing managed care contracts to ensure financial optimization and compliance, ... and contract performance. You will support cross-functional teams with managed care analytics and forecasting, ensuring compliance...role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k)… more
- Cardinal Health (Sacramento, CA)
- …in defining, developing, and executing go-to-market strategies that drive engagement with Managed Care Organizations (MCOs), health plans, and payor networks. ... lifecycle marketing. The ideal candidate brings expertise in the managed care landscape-paired with the ability to...to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health… more
- EPAM Systems (San Francisco, CA)
- As the **Director, Next-Generation Managed Services** AI-Powered Managed Services at EPAM Systems, you will revolutionize our service delivery model by ... while leading multiple strategic client accounts. You'll architect next-generation managed services that integrate DevOps, SRE principles, and intelligent automation… more
- LA Care Health Plan (Los Angeles, CA)
- …and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience ... with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed ...+ Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision + Wellness Program + Volunteer Time Off… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Bachelor's Degree Experience Required: At least 2 years of experience in Managed Care with specific experience in resolving member and provider ... apply regulations. At least 5 years of experience in Managed Care working with Medicare, Medi-Cal and...+ Tuition Reimbursement + Retirement Plans + Medical, Dental and Vision + Wellness Program + Volunteer Time Off… more
- Ventura County (Ventura, CA)
- …the current principles and techniques of diagnosis and treatment + Experience with managed care + Experience and current knowledge of Quality Assurance, ... 401(k) plan. + Health Plans - Medical, Dental, and Vision Plans for you and your dependents. You are...of Medicine and includes the following: + Experience with managed care + Experience and current knowledge… more
- Sharp HealthCare (San Diego, CA)
- …Nursing, and/or Home Health + 3 Years Medical Management experience, preferably in managed care , with supervisory experience + 2 Years Medical Management ... experience, preferably in a managed care setting + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred Qualifications** +… more
- Humana (Sacramento, CA)
- …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... 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