- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Customer Service Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the...to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects… more
- CVS Health (Sacramento, CA)
- …extensive plan writing experience supporting self-funded or fully insured plans . + Demonstrated ability to work independently as a critical thinker, ... for drafting, reviewing, and amending or restating medical, dental, and vision plan documents, including Summaries of Benefits and Coverage (SBCs). You will be… more
- University of Southern California (Los Angeles, CA)
- …faculty, staff and retirees. The position reports to the AVP of Health Plans . Main responsibilities will include plan administration, oversight of operations and ... member services and in collaboration with senior leaders monitor plan expenses. The Associate Director, Health Plans :...monitor plan expenses. The Associate Director, Health Plans : . Plans and develops health and… more
- Ventura County (Ventura, CA)
- …continuous County service, an additional 2% non-elective contribution will be made to the 401(k) plan . + Health Plans - Medical, Dental, and Vision Plans for ... Medical Director, Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113) Apply Medical Director, Ventura… more
- Prime Healthcare (Ontario, CA)
- …data, the VP will identify financial savings across all aspects of the Employee Health Plans . The VP of Health Plan Operations and Claims will provide strategic ... This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of… more
- Sharp HealthCare (San Diego, CA)
- …networks. + Assists the Chief Medical Officer in designing and implementing corrective action plans to address issues and improve plan and network managed care ... and updates as required in program descriptions, Annual Work Plans and policy and procedures to various plan... Plans and policy and procedures to various plan committees, and the SHP Chief Medical Officer. +… more
- Sharp HealthCare (San Diego, CA)
- …better understand plan designs and benefit intent as directed.Assist with plans and benefits hand-offs to internal and external partners; develop and manage ... Benefits Administration Analyst provides operational support to ensure benefit plans are designed appropriately and consistently and performance guarantees, service… more
- Sharp HealthCare (San Diego, CA)
- …networks. + Assists the Chief Medical Officer in designing and implementing corrective action plans to address issues and improve plan and network managed care ... and updates as required in program descriptions, Annual Work Plans and policy and procedures to various plan... Plans and policy and procedures to various plan committees, and the SHP Chief Medical Officer. +… more
- Magellan Health Services (San Diego, CA)
- …including ongoing monitoring of an appropriate and effective person-centered care plan , member education and care management. Conducts initial and concurrent review ... necessity criteria. Responsible for the development of individualized care plans for high and moderate stratified members in the...other support opportunities to develop a long term care plan to guide the member through their mental health… more
- Sharp HealthCare (San Diego, CA)
- …of policies and relevant background information for other departments to better understand plan designs and benefit intent. Manage all plans and benefits ... lines of business (Medicare Commercial, Government, etc.) to ensure benefit plans are designed appropriately and consistently and performance guarantees, service… more
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