Managed Care Jobs in San Diego
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Search Results - Managed Care Jobs in San Diego
Molina Healthcare-San Diego-
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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Pacific Health Group-San Diego-workable.com-
monitors pending applications, follows up on eligibility issues, assists with denied or discontinued coverage, supports appeals and submission of requested documentation, helps members navigate Managed Care Plan enrollment, and tracks each case until...
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Molina Healthcare-San Diego-
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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Samsung Electronics America-San Diego-
demonstrate proficiency with MS Office package, including Excel, Word, and PowerPoint; as well as Outlook, Internet Explorer, and Google Chrome
• Familiarity with clinical and economic outcome data, reimbursement, and managed care policies and procedures...
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Molina Healthcare-San Diego-
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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Samsung Electronics America-San Diego-
and Google Chrome
• Familiarity with clinical and economic outcome data, reimbursement, and managed care policies and procedures is highly desirable
• Must be able to assemble facts from various areas, analyze data, and provide informed recommendations...
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San Diego-icims.com-
or Managed Care setting
• Associate’s degree in Nursing from an accredited institution required
• Bachelor’s degree in Nursing from an accredited institution preferred
• Possession of valid Certified Site Reviewer Certificate issued from DHCS or participating...
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Heartland Hospice-San Diego-
resources; good oral and written communication skills; documentation and program management; knowledge of general nursing practice; thorough knowledge of managed care principles, regulatory guidelines (i.e., Medicare, Medicaid, ACHC, and human resource...
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McKesson-Irving, 1170 mi from San Diego-
within clinical teams in managed care pharmacy, pharmacy consulting, health system, or pharmacy benefit manager environments * Previous technical work experience with Microsoft Office Suites, data visualization software, data analytics reporting...
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San Diego Wellness Collaborati-San Diego-trinethire.com-
framework. These teams manage the referral, authorization, and implementation of Enhanced Care Management (ECM) and Community Supports (CS) housing services for Medi-Cal members, in close coordination with managed care plans (MCPs), community referring...
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Pacific Health Group-San Diego-workable.com-
behavioral health services while expanding access to care through innovative community engagement, street outreach collaboration, and integrated care initiatives. The Program Manager partners closely with executive leadership, county agencies, managed care...
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Abbott Laboratories-San Diego-jobs.abbott-
Abbott customers. Collaborate with various channels partners within, HCP, Managed Care, Retail and Point of Care organizations. Establish strong relationships with a broad base of internal and external health care constituents (e.g., physicians, nurses...
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San Diego-icims.com-
and maintaining effective provider relationships. The Specialist will work closely with the Medical Director (MD), Associate Medical Director (AMD), and the Contracting & Managed Care Officer (CMCO).
Responsibilities:
Performance Area 1: Provider Account...
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Pacific Health Group-San Diego-workable.com-
Verify MediCal eligibility and aid codes for all Clubhouse members monthly (and prior to claiming), including share-of-cost, other health coverage (OHC), and managed care assignment issues that affect SMHS claiming.
• Coordinate resolution of eligibility...
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San Diego-icims.com-
insurance adjusters and managed care coordinators regarding status
• Develop and implement patient management plans, and assist in provision of continuity of care
• Responsible for participating in Quality Assurance, Performance Improvement activities...
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