- Insmed Incorporated (Los Angeles, CA)
- …and issue/problem solving.Provide medical and scientific support to payers, commercial managed markets, and related health care organizations to facilitate ... objective, scientific and evidence-based medical information, and education to health care customers within managed markets/healthcare/payor systems, in addition… more
- Fresenius Medical Center (Inglewood, CA)
- …POS, etc) in the state of California. Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- LA Care Health Plan (Los Angeles, CA)
- …At least 5 years minimum working directly within a health plan or managed care organization; experience in Medicaid or government-sponsored health insurance ... Senior Director , Enterprise Portfolio Management Office Job Category: Management/Executive...$232,100.00 (Mid.) - $292,274.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- University of Southern California (Los Angeles, CA)
- …(MBA) or Health Administration (MHA) or related. . Knowledge and experience in managed health care . General understanding including but not limited to: claims ... Associate Director , Health PlansApply (https://usc.wd5.myworkdayjobs.com/ExternalUSCCareers/job/Los-Angeles-CA University-Park-Campus/Associate- Director --Health-Plans\_REQ20160798/apply) Keck… more
- Grifols Shared Services North America, Inc (Los Angeles, CA)
- …presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and ... more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management, performance, and coaching of a team of MSL direct… more
- Grifols Shared Services North America, Inc (Los Angeles, CA)
- …the industry trends * Understanding of US payer market dynamics and how managed care organizations make decisions across commercial and public channels * ... in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for...teams to expand key initiatives and strategies to the managed markets customer base, which consists of payers, GPOs,… more
- Elevance Health (Los Angeles, CA)
- …+ 5+ years of clinical practice experience, with transition into payer, managed care , or healthcare leadership preferred. + Experience advising medical ... **Manager, Medical Director - Transformation Initiatives** Location: This role requires...+ **Real-time Decisioning & Analytics (RDA)** + **Cost of Care / Payment Integrity** + ** Care Management… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …Statement/Position Summary:** This position is responsible for directing and coordinating the managed care policies, goals, and objectives related to contract ... Group leadership in working with Physician Organizations in the market regarding managed care contracts, strategies for improving market share and opportunities… more
- UCLA Health (Los Angeles, CA)
- …for a medical group, IPA, or Health Plan, required + In-depth understanding of managed care , MSO functions, and population health services, required + Experience ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation, and implementation of multiple clinical… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …Join Kite and help create more tomorrows. **Job Description** The **Senior Director ,** **Head of** **US Trade,** **Pricing and Contract** **ing** reports to the ... and provider contracts, incl. ensuring that all contracts are managed in a compliant manner + Lead all contracting...of private and public payers, across all settings of care , to include the complexities of reimbursement in each… more
- Compass Group, North America (Los Angeles, CA)
- …CCL Hospitality Group has a philosophy rooted in caring for the individuals who care for our guests. Our most significant competitive advantage is our team members. ... how we drive mutual success that leaves lasting impressions. **Job Summary:** The Director of Dining Services is the strategic business leader of the community's… more
- Molina Healthcare (Los Angeles, CA)
- …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- LA Care Health Plan (Los Angeles, CA)
- …and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience ... and receives clinical supervision as needed from the Medical Director of Care Management. The position is...with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed … 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 ... net required to achieve that purpose. Job Summary Reporting to the Director of Enhanced Care Management (ECM), the ECM Manager will be responsible for overseeing… more
- Elevance Health (Los Angeles, CA)
- …HS diploma or equivalent and a minimum of 2 years of experience in a managed care healthcare setting; or any combination of education and experience, which would ... director . + Prepares nurse summaries for Quality of Care cases and forwards to Medical Director ...of Care cases and forwards to Medical Director for review and determination. + Ensures grievances are… more
- LA Care Health Plan (Los Angeles, CA)
- …Experience working in a cross functional work environment. Preferred: Experience in Medi-Cal managed care . 1 year of experience in UM/Prior Authorization. Skills ... Range: $47,840.00 (Min.) - $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of… more
- Cedars-Sinai (Beverly Hills, CA)
- …Research Operations is accountable to the Department Chair and/or Institute Executive Director and serves as the primary source of information for the department. ... for the department and organization. Strategizes and collaborates with the Director and senior leadership, along with Academic Affairs regarding development and… more
- A Bright Future, Inc. (Los Angeles, CA)
- …of the entire staff assigned to work at specific homes, coordinating personal care , training, and support to meet the goals and objectives of the individuals ... vendor's established policies, under the general supervision of the director . TITLE: Community Support Facilitator STATUS: Full-Time, Regular CLASSIFICATION:… more
- UCLA Health (Los Angeles, CA)
- …- $48.82 Hourly Qualifications + Minimum of 2 years' experience working in a Managed Care Case Management and care coordination environment preferred. + ... High school diploma, GED or equivalent. + Experience processing Inpatient and ambulatory Managed Care referrals. + Vodavi phone system experience preferred. +… more
- UCLA Health (Los Angeles, CA)
- …collaboratively with the patient, Faculty Practice Group, community resources, other providers, managed care operations, the UCLA Health System, and health plans ... coordinator discharge planning. Under the direction of the Assistant Director , the ICM Nurse Case Manager - Oncology performs...the ICM Nurse Case Manager - Oncology performs complex care coordination for high-risk MA cancer patients. The Nurse… more
