- Lompoc Valley Medical Center (Lompoc, CA)
- …when applicable. + Coordinates resources to aid in direct patient payments of claims when necessary. + Utilizes a variety of technical platforms including the ... to telephone and verbal requests. + Provides feedback to Director of reimbursement situations that may result in risk... of reimbursement situations that may result in risk management action. + Must work well under stress or… more
- City and County of San Francisco (San Francisco, CA)
- …projects and workgroups. + Provides technical support for assigned program management systems to ensure smooth functionality and responsiveness to stakeholders. + ... to the general duties above: + Detects, investigates, and prevents fraudulent claims for public assistance to avoid welfare fraud and other financial crimes.… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... Administration team members. Assumes additional responsibilities in the absence of the Director . **Required Qualifications** + 5 Years in HMO or Health Insurance … more
- Sedgwick (Sacramento, CA)
- …department or special projects as assigned by the Finance Manager or Director . + Process account collections/receivables. + Reconcile claims activity between ... To prepare the necessary reports and communicate the results to management . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Creates and maintains accurate and… more
- Stanford Health Care (Menlo Park, CA)
- …job.** The Facilities Services division provides planning, design and construction management for Stanford Medicine, supporting its mission of improving health ... and research. The Facilities Construction business unit provides construction management for medium-to-large multi-year capital projects at Stanford Medicine.… more
- Dignity Health (Bakersfield, CA)
- …all necessary areas that collaborate with the contracting department (ie, Claims , Utilization Management /Authorizations, Benefits, and Finance) to provide ... **Position Summary:** The Manager, Network Strategy and Contracting reports to the Director of Provider Contracting. Key areas of oversight include negotiation of… more
- Healthcare Services Group, Inc. (Sacramento, CA)
- …Job Type:Full-Time - Remote (20% Travel) Reports To: Human Resources Director Responsibilities Healthcare Services Group (HCSG) is currently seeking to fill ... join our growing Corporate Team! This position reports to the Human Resources Director . This role is primarily responsible for the investigation, and resolution of… more
- Molina Healthcare (Riverside, CA)
- …and JOCs. Entail heavy negotiations. Maintains critical Complex provider information on claims and provider databases. Synchronizes data among multiple claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** Manages the Plan's Provider Contracting… more
- City and County of San Francisco (San Francisco, CA)
- …analytical excellence? Are you passionate about efficiency, risk mitigation, and have risk management experience in a municipal setting? If so, come join our team! ... and Compliance Manager oversees all aspects of the Airport's comprehensive risk management and compliance programs and manages a staff of Airport employees,… more
- LA Care Health Plan (Los Angeles, CA)
- …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:… more