Managed Care Jobs in Rancho Cucamonga
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Search Results - Managed Care Jobs in Rancho Cucamonga
SIMPLE SOLUTIONS PSYCHOTHERAPY-Rancho Cucamonga
field with three (3) or more years of progressive case management experience in Medi-Cal managed care, ECM, Community Supports, Health Homes, Whole Person Care, behavioral health, hospital case management, or community-based care coordination.
Equivalent...
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Rancho Cucamonga
any other duties as required to ensure Health Plan operations and department business needs are successful.
Qualifications:
Education & Requirements
• At least three (3) years of outreach or managed care experience required
• Experience in health...
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icims.com -
Inland Empire Health Plan-Rancho Cucamonga
coaching, performance management)
• Proven ability to collaborate across Finance, FP&A, Clinical Operations, and Provider Network
• Bachelor’s degree in a quantitative, financial, or health-related field
• Preferred: experience in Medicaid managed care...
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SIMPLE SOLUTIONS PSYCHOTHERAPY-Rancho Cucamonga
license, reliable transportation, and an acceptable driving record.
• Ability to travel throughout the assigned service area.
Preferred QualificationsExperience with:
• CalAIM Community Supports
• Enhanced Care Management (ECM)
• Medi-Cal managed care...
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Inland Empire Health Plan-Rancho Cucamonga
management for the Risk Adjustment team
• Maintain SOPs, workflow documents, and control checklists for compliance and continuous improvement
• Perform other duties to support health plan operations
Key requirements
• 5+ years in managed care, healthcare...
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Rancho Cucamonga
environment
• Data entry specialist experience preferably in an HMO or Managed Care setting
• Utilization Management experience preferred
• High School Diploma or GED required
Key Qualifications
• Requires knowledge of ICD 10 and CPT codes. Knowledge...
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icims.com -
Inland Empire Health Plan-Rancho Cucamonga
related field (e.g., Economics, Finance, Public Health, Health Administration, Statistics, Mathematics, Data Science) from an accredited institution
Preferred:
• Experience in Medicaid managed care or other publicly sponsored health plan environments...
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appcast.io -
Rancho Cucamonga
requirements, the Medicare Managed Care Manual, audit protocols, evolving CMS guidance, and IEHP organizational policies. This role independently leads and oversees complex Medicare Stars quality initiatives involving the prioritization of resource utilization...
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icims.com -
Rancho Cucamonga
years of experience as a data entry specialist
• Data entry specialist experience preferably in an HMO or Managed Care setting
• Utilization Management experience preferred
• High School Diploma or GED required
Key Qualifications
• Must have a valid...
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icims.com -
Rancho Cucamonga
Management processes
• SDOH, Health Equity, Community Resources, Person-Centered Care, Alternative Care Models
• Managed care claims, payment processes, and insurance terminology
• Strongly preferred strong knowledge and understanding of:
• Risk...
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icims.com -
Rancho Cucamonga
policy communication skills
• Preferred experience in the following areas:
• Experience supporting managed care claims, encounters, and billing dispute resolution
• Background in high-volume, operationally complex environments with multiple vendor...
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icims.com -
Rancho Cucamonga
of progressively responsible experience within a managed care health plan or closely related industry, with direct, hands on expertise in compliance requirements established by CMS, DHCS, DMHC, and/or Covered California required
• Demonstrated experience engaging...
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icims.com -
Rancho Cucamonga
with various managed care compensation methodologies related to Medicaid, Medicare and Marketplace government-sponsored programs
• Bachelor’s degree in a related field from an accredited institution required
• Master’s degree in a related field from...
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icims.com -
Rancho Cucamonga
medical records and claims preferred
• Experience in managed care, MediCal, Medicare preferred
• High school diploma or GED
• Associate’s degree in health care or a related field from an accredited institution
• Possession of an active, unrestricted...
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icims.com -
Rancho Cucamonga
are successful
Qualifications:
Education & Requirement
• A minimum of five (5) years of progressive experience in managed care, healthcare EDI data management, or health plan operations, with a dedicated focus on encounter data reconciliation, RAPS/EDPS...
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icims.com -
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