Managed Care Jobs in Rancho Cucamonga
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Search Results - Managed Care Jobs in Rancho Cucamonga
Rancho Cucamonga
functional areas such as Compliance, Regulatory Affairs or similar groups
• The ideal candidate will have prior in-house experience in a public entity, managed care organization or health system
• Juris Doctorate (J.D.) from an American Bar Association...
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Molina Healthcare-Los Angeles, 38 mi from Rancho Cucamonga
managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational...
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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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Molina Healthcare-Riverside, 10 mi from Rancho Cucamonga
of leadership experience within a managed care organization , with a proven ability to lead teams, drive performance, and support member-centered care initiatives. Strong leadership, collaboration, and operational management skills are essential to successfully...
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Rancho Cucamonga
other duties as required to ensure Health Plan operations and department business needs are successful.
Qualifications:
Education & Requirements
• Minimum or five (5) or more years in managed care operations requierd, working with one or more...
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Insperity-Los Angeles, 38 mi from Rancho Cucamonga
of medical claims payment experience in an HMO environment (i.e., MSO, IPA, or health plan)
• Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
• Experience with CPT-4, ICD-10-CM, RBRVS, ASA, and HCPCS, as well...
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Rancho Cucamonga
in the Experience Requirements above
• Master’s degree from an accredited institution preferred
Key Qualifications
• Understanding of project lifecycle methodologies and LEAN methodologies
• Knowledge of managed care, healthcare, health plans, government products...
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Molina Healthcare-Los Angeles, 38 mi from Rancho Cucamonga
health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination...
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Rancho Cucamonga
as it pertains to covered benefits.
• The local and regional Member and Provider demographics and relationships.
• Healthcare and/or transportation industry, specifically regarding managed care organizations.
• Non-Emergency Medical Transportation (NEMT/NMT...
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UCLA Health-Los Angeles, 38 mi from Rancho Cucamonga
physicians, patient and family. Ability to represent Medical Center in site visits and review by Managed Care and insurance groups. (Required)
/n
• Excellent organizational skills, proficiency in meeting deadlines, ability to work independently...
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