- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. This includes medical, vision, dental,… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with a high level of productivity and focus… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines.… more
- Pacific Building Group (San Diego, CA)
- …field teams throughout the project lifecycle. * Ensure compliance with all company safety and quality standards. * Support business development through strong ... industry relationships and performance. Minimum Qualifications: * 5+ years of drywall construction project management and estimating experience. * Proven understanding of drywall systems, construction means and methods, and project sequencing. * Proficiency… more
- Philips (CA)
- …documentation, and other related paperwork. Adhere to established training, quality, and safety requirements. + Utilize tools, support , resources, and escalation ... processes within required time frames to resolve customer and system problems timely and effectively. Complete PMs, FCOs, installation and all related tasks (diagnose and resolve electronic, network, and mechanical problems). + Approximately 70% travel across… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …issues promptly. + Ensure the pharmacy environment is clean, organized, and adheres to safety and health standards. + Support the pharmacy team in administrative ... tasks such as filing, data entry, and processing insurance claims. + Collaborate with team members to improve workflow and enhance the overall efficiency of pharmacy operations. + Adhere to all company policies, procedures, and regulatory requirements to… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary ... Manager, Financial Compliance Audit (Finance) has a $10,000 SIGN-ON BONUS. This role is responsible for the timely and quality delivery of a variety of complex areas across all lines of business, including Medi-Cal, Covered California, D-SNP, and PASC-SEIU.… more
- LA Care Health Plan (Los Angeles, CA)
- …care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The ... Health Educator II Registered Dietitian provides nutritional counseling as Medical Nutrition Therapy and Diabetes Self-Management Education and completes dietary assessments for the Medically Tailored Meals Program via telehealth for LA Care Health Plan's… more