- Dignity Health (Long Beach, CA)
- …Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** CommonSpirit Health ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression... Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Bakersfield, CA)
- …Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and payer environment preferred **Where You'll Work** Bakersfield Memorial ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression... Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Long Beach, CA)
- …Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** CommonSpirit Health ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression... Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Glendale, CA)
- …Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** Founded in ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression... Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Elevance Health (Cerritos, CA)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... **Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role...end results. + Works side by side with their manager . **Minimum Requirements:** Requires BA/BS degree in Mathematics, Statistics… more
- Dignity Health (Merced, CA)
- …within 3 months of hiring + Able to apply clinical guidelines to ensure progression of care . + Knowledge of managed care and payer environment preferred. + ... **Job Summary and Responsibilities** **Position Summary** The RN Care Coordinator is responsible for overseeing the progression...five (5) years of nursing experience + Certified Case Manager (CCM), + Accredited Case Management (ACM-RN), or UM… more
- BrightSpring Health Services (San Diego, CA)
- …communicating (verbally and in writing) with skilled nursing, assisted living, subacute and managed care organizations to assess market needs. + Works with RVP ... and negotiating contracts for products and service. Prior experience in B2B Long-Term Care Sales or Pharmacy Services Sales a plus. Remote with 50% Travel… more
- LA Care Health Plan (Los Angeles, CA)
- …of experience performing claims audits or claims processing related to Medi-Cal, Medicare, and/or other managed care product lines similar to LA Care 's LA ... $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...audits timely. Performs ongoing tasks as assigned by the manager of Financial Compliance which may include compiling Monthly… more
- UCLA Health (Pasadena, CA)
- …to perform administrative work. * Familiarity and knowledge of authorization process & managed care programs UCLA Health welcomes all individuals, without regard ... Description Reporting directly to the Manager , providing direct support to the physicians and...the physicians and patients for assigned primary and/or specialty care physicians. Major duties include but are not limited… more
- Ventura County (Ventura, CA)
- …correctly interpreting, and accurately applying regulatory requirements of the Department of Managed Health Care (DMHC) and standards; + Administers and oversees ... Experience with Utilization Management and/or Quality Assurance in a Managed Health Care Plan. + Experience working...Care Plan. + Experience working as a case manager in a health plan case managing complex cases.… more