• Manager, Enhanced Care Management (Clinical)

    LA Care Health Plan (Los Angeles, CA)
    …(Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to ... residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make...as well as the oversight of ECM Providers and Plan Partners' delegated functions related to ECM. Collaborates with… more
    LA Care Health Plan (10/16/25)
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  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... long-term career. JOB SUMMARY: Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims. Collaborates with other Health plan more
    Centers Plan for Healthy Living (10/14/25)
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  • Manager, Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …and implementation. *General Knowledge of HIPAA Confidentiality Laws About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how ... self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers… more
    Brighton Health Plan Solutions, LLC (10/11/25)
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  • Clinical Appeal and Grievance Nurse

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Preferred experience in a Third-Party Administrator (TPA) setting About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how ... self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers… more
    Brighton Health Plan Solutions, LLC (10/05/25)
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  • Support Specialist, Casualty

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …years' experience + Bachelor's degree or equivalent experience About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how ... self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers… more
    Brighton Health Plan Solutions, LLC (10/04/25)
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  • Specialty Health Plans Auditor III Claims

    LA Care Health Plan (Los Angeles, CA)
    …(Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to ... residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make...(DMHC) claims data submissions for LA Care and its Plan Partners (PPs), and delegates done each quarter and… more
    LA Care Health Plan (10/03/25)
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  • Customer Solution Center Training Specialist II

    LA Care Health Plan (Los Angeles, CA)
    …(Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to ... low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make sure our members get… more
    LA Care Health Plan (09/09/25)
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  • Claims Supervisor

    Brighton Health Plan Solutions, LLC (NC)
    …or comparable experience in the healthcare field preferred. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how ... self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers… more
    Brighton Health Plan Solutions, LLC (08/08/25)
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  • Enhanced Care Management Clinical Specialist II

    LA Care Health Plan (Los Angeles, CA)
    …(Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to ... residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make...the ECM Provider. Identify any gaps in the Care Plan services or regulatory compliance and provide coaching and… more
    LA Care Health Plan (10/14/25)
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  • Intake RN

    Centers Plan for Healthy Living (Margate, FL)
    Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... a comprehensive assessment (UASNY) to determine eligibility and initial plan of care + Develops plans of cares for...and State and Federal guidelines and regulations. + Communicates plan benefits clearly and easily to prospects and referral… more
    Centers Plan for Healthy Living (10/14/25)
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