- Select Medical (Westlake Village, CA)
- …therapist to join our team. Mentoring will be available as the clinic manager is a Sports Certified Specialist and highly trained in general orthopedics, sports ... Plan with Company Match Paid Time Off , Sick Time, and Holidays Markets Managed Locally Flexible Spending Accounts Employee Discounts and perks on good and services… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …and problem resolutions regarding payment issues with all contracted payors. Manages the contract review process for RCSSD 3rd party contracts , contracts ... JOB SUMMARY: Responsible for seeking contract opportunities, reviewing contract language and...and terms, conducting data analysis on financial terms, negotiating contracts , and managing executed contracts for all… more
- Takeda Pharmaceuticals (Sacramento, CA)
- …to the best of my knowledge. **Job Description** **About the role:** As a Manager , Payer Contracts , you will lead the development and implementation of assigned ... strategic terms. + Will lead the technical and analytical support for payer contracts . + Independently work with Legal, Managed Markets and external customers… more
- Robert Half Legal (Rancho Cucamonga, CA)
- …Healthcare Organization! You will be joining a large legal team and become a Managed Care expert (MediCare). You will advise on regulatory and compliance issues, ... days per week (Tuesday-Thursday). The Counsel will be a manager -level position. The Counsel reports to the General Counsel...Ability to commute to Inland Empire 3 days/week + Managed care experience + Litigation experience in… more
- Live Nation (CA)
- … Managed Pricing Analyst Division: Revenue & Demand Management Line Manager : Manager , Managed Pricing Services Contract Terms: Regular/Full - Time THE ... (including religious dress and grooming practices), family and medical care leave or the denial of family and medical... leave or the denial of family and medical care leave, mental or physical disability (including HIV and… more
- CVS Health (Sacramento, CA)
- …Required Qualifications + Minimum 3+ years related experience, proven and proficient managed care network negotiating skills. + Proven working knowledge of ... health care more personal, convenient and affordable. Position Summary The Contract Negotiation Manager will negotiate and execute high-level review and… more
- LA Care Health Plan (Los Angeles, CA)
- …At least 4 years of recent care management experience in a hospital or managed care setting, such as a health insurance environment and/or experience as ... CCS, Regional Center) functions. Assures departmental compliance with: All contracts (ie CMS, DHCS, Covered California, PASC-SEIU, First 5LA,...care manager in home health or hospice… more
- LA Care Health Plan (Los Angeles, CA)
- …At least 1 year of experience in leading program/project teams. Preferred: Managed care experience. Skills Required: Demonstrated critical thinking, problem ... Care Management Initiatives Program Manager II...regulatory and accreditation requirements such as those stated in contracts , memorandums of understanding, CalAIM Policy Guides, National Committee… more
- LA Care Health Plan (Los Angeles, CA)
- …Required: Minimum of 6 years of recent care management experience in a managed care setting, such as a health insurance environment and/or experience as ... state/federal compliance are met. + Track data related to contract compliance and member complaints. + Formulate reports and...care manager in a community based organization...care manager in a community based organization with at least… more
- LA Care Health Plan (Los Angeles, CA)
- …Required: Experience serving Medi-Cal population. Preferred: Understanding of Medi-Cal managed care model, eligibility requirements, benefits, enrollment ... Product Solutions Manager III Job Category: Administrative, HR, Business Professionals...processes, and regulatory requirements governing Medi-Cal managed care plans. Understanding of … more
- Illumination Foundation (Cerritos, CA)
- …Care Management needs are sufficient to be managed by a ECM Lead Care Manager or require the Consultant's intervention in the form of recommendations to ... goals + Work with all Medi-Cal Managed Care Plan Illumination Foundation ECM contracts among three Southern California regions: Los Angeles, Orange, and… more
- LA Care Health Plan (Los Angeles, CA)
- …Intervention and Outcome (ISEIO) framework to address Behavioral Health and managed care operational challenges that require collaboration with multiple ... project teams. A minimum of 2 years of experience working within a managed care organization. Experience building relationships with organizations and business… more
- LA Care Health Plan (Los Angeles, CA)
- …Independent judgment and action skills to facilitate change as needed. Knowledge of managed care industry standard performance assessment methods. Able to work ... Clinical Quality Program Manager II (CAHPS) Job Category: Clinical Department: Quality... Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Shared Services Program Manager II (Limited Duration- 12 months)) Job Category: Administrative, HR, Business Professionals Department: Claims Data and ... $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a… more
- Elevance Health (Costa Mesa, CA)
- **Sign-on Bonus:** $3,000 The **Behavioral Care Manager ** **II** is responsible for completing clinical assessments, screenings, and managing crisis calls in a ... of experience with complex psychiatric/substance abuse cases required. + Prior managed care experience required. **Preferred Skills, Capabilities, and… more
- LA Care Health Plan (Los Angeles, CA)
- …operations. At least 3-4 years of supervisory/ management experience in healthcare or managed care industry. Experience with BI reporting tools. Knowledge and ... Manager , Encounters Job Category: Administrative, HR, Business Professionals...Care Services (DHCS) and other government agencies, understanding contract obligations, requirements of encounter data extraction and submission.… more
- Intermountain Health (Sacramento, CA)
- …FEHB, Marketplace Qualified Health Plans and fully-funded and self-funded Commercial plan. The Care Manager 1 - Remote is a Registered Nurse who partners ... and consistent with goals and objectives of referral, payer contract , or established care processes. + Maintains...an ambulatory care setting + Experience in care management or managed care … more
- LA Care Health Plan (Los Angeles, CA)
- …in a related capacity. At least 3 years relevant health plan or managed care experience. Audit/oversight experience. Experience with Medi-Cal and Medicare ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...$152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- Stanford Health Care (Menlo Park, CA)
- …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **Additional Job Description:** Located in the heart of Silicon Valley, Stanford ... Health Care 's mission is to heal humanity through science and...adequate staffing levels to support daily operations. + Oversees contract administration needs including initiation, vendor performance and financial… more
- Takeda Pharmaceuticals (Sacramento, CA)
- …regional and national level. + Use available resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who are ... future at Takeda. Join us as a Key Account Manager in our Minneapolis, MN geography. Here, everyone matters,...impacted (ie Sales Forces, Leadership, and Managed Care Accounts). + Work within established… more
