• Medicaid Provider Hospital

    Humana (Sacramento, CA)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (07/29/25)
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  • Provider Contracts Manager

    Molina Healthcare (Long Beach, CA)
    …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
    Molina Healthcare (07/17/25)
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  • Manager, Provider Contracts

    Molina Healthcare (Riverside, CA)
    …contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting, ... etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business,… more
    Molina Healthcare (07/25/25)
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  • Assistant General Counsel - Hospital

    Prime Healthcare (Ontario, CA)
    …to join our corporate team! Responsibilities The Assistant General Counsel - Hospital Operations must be a transactional/regulatory attorney with experience in the ... both the corporate and local levels across the health system. This attorney will provide daily counsel on a range of operational issues. This attorney will prepare a… more
    Prime Healthcare (06/20/25)
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  • Utilization Review Clinician (Santa Rosa)

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …Demonstrate a working knowledge of Medical Necessity and regulatory standards (Medicare, Medicaid and Manage Care) + Training: Provide staff in-service training ... ABOUT US: Formerly Aurora Santa Rosa Hospital , SRBHH was opened in 2016 and is...both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review… more
    Sacramento Behavioral Healthcare Hospital (07/04/25)
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  • Corporate Senior Government Reimbursement

    Prime Healthcare (Ontario, CA)
    …preparing and completing entire Medicare and Medicaid cost reports for a multi-state hospital system and provide the support at audit + Knowledge of Medicare ... government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and understanding the complexity… more
    Prime Healthcare (06/18/25)
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  • Utilization Management Nurse

    CenterWell (Sacramento, CA)
    …experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or... Experience a plus + Current nursing experience in Hospital , SNF, LTAC, DME or Home Health. + Bilingual… more
    CenterWell (08/02/25)
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  • Vice President, Compliance Business Partner…

    Option Care Health (Sacramento, CA)
    **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
    Option Care Health (05/30/25)
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  • HIM Clinical Coding Specialist III - System Coding…

    Sharp HealthCare (San Diego, CA)
    …Association (AHIMA); HS Diploma or Equivalent; Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC); Registered Health ... and APC's) as mandated. Uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, HCAL data financial and… more
    Sharp HealthCare (05/16/25)
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  • Vice President - Mid-Revenue Cycle

    Stanford Health Care (Palo Alto, CA)
    …planning, leadership, and operations support for Health Information Management, Hospital and Professional Coding Services, Charge Capture procedures, Revenue ... revenue capture and clinical documentation is effective in optimizing all Technical ( hospital ) and Professional revenue and quality measures outcomes. Acts a liaison… more
    Stanford Health Care (07/23/25)
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