- HealthTrust Workforce Solutions (Campbell, CA)
- …are fully aware of the business and industry imperatives impacting the MSO . 12. Provides business development initiative; provides analytical support and meaningful ... insights, as requisite. 13. Reviews operating results of the MSO , compares them to established objectives, and takes steps to ensure that appropriate measures are… more
- HCA Healthcare (Campbell, CA)
- …experience negotiating and managing contracts either in a health plan or IPA/ MSO model + Experience negotiating DOFRs, physician and ancillary agreements and Letters ... of Agreement + Working knowledge of claims operations, credentialing process and overall MSO operations + Minimum of three years of claims experience and/or one year… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & ... shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally recognized medical organizations federal… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Reporting to the Director of Claims and Systems Administration and functioning as an independent, the Compliance Specialist's primary function is to ensure the ... Managed Care business unit is meeting compliance with rules, policies, and procedures of DHCS and DMHC, Federal and State law regulations as they pertain to both Medi-Cal and Commercial lines of business. Interprets and ascertains regulatory changes,… more
- Dignity Health (Bakersfield, CA)
- …and patient satisfaction in support of the optimization of Dignity Health MSO 's performance relative to value-based contracts. The Director will lead a team ... results for hands on data science and analytics functions for Dignity Health MSO leadership, day-to-day oversight of the population health analytics team members and… more
- UCLA Health (Los Angeles, CA)
- …Utilization Management for the Faculty Practice Group (FPG) Management Services Organization ( MSO ). Reporting to Chief Medical Officer of Faculty Practice Group and ... of Utilization Management and its integration with other patient facing programs within the MSO . You will oversee and direct key initiatives, ensuring that MSO … more
- Dignity Health (Bakersfield, CA)
- …The position will work closely with the Quality & Risk team for the MSO to grow program offerings and help achieve a competitive advantage within our services ... The purpose of Dignity Health Management Services Organization (Dignity Health MSO ) is to build a system-wide integrated physician-centric, full-service management… more
- Dignity Health (Bakersfield, CA)
- …value. **Preferred Qualifications:** - Experience within a Management Services Organization ( MSO ) or Population Health enterprise preferred. - Lean Six Sigma or ... The purpose of Dignity Health Management Services Organization (Dignity Health MSO ) is to build a system-wide integrated physician-centric, full-service management… more
- Dignity Health (Bakersfield, CA)
- …The purpose of Dignity Health Management Services Organization (Dignity Health MSO ) is to build a system-wide integrated physician-centric, full-service management ... Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical… more
- Dignity Health (Bakersfield, CA)
- …The purpose of Dignity Health Management Services Organization (Dignity Health MSO ) is to build a system-wide integrated physician-centric, full-service management ... Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical… more