Managed Care Jobs in San Diego
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Search Results - Managed Care Jobs in San Diego
Integrity Healthcare...-San Diego
issues. Qualifications MD or DO degree required. Board Certification in Internal Medicine strongly preferred. Minimum 5 years of clinical experience required. 2+ years of managed care, health plan, or utilization management experience preferred.
Strong...
San Diego Wellness Collaborati-San Diego
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...
trinethire.com -
Behavioral Health Works-San Diego
authorization requirements and maintain knowledge of commercial insurance, Medicaid, and managed care guidelines.
• Assist with resolving authorization-related issues, denials, and appeals.
• Maintain accurate authorization records and documentation within...
workable.com -
San Diego
containment background, such as utilization review or managed care also useful.
• One to two plus years of recent clinical experience and/or one to two years of recent managed care experience.
• Achieves recognized certification in case management within...
icims.com -
Randstad-San Diego
account balances for commercial, government, & managed care payors as assigned. Employee is required to identify & report payor issues to their leadership. It is a requirement to be experienced to read, interpret & apply complex payor contract language...
randstadusa.com -
Pacific Health Group-San Diego
systems, managed care, and community resources
• Excellent communication, empathy, and cultural competence
• Strong organizational and time management skills
• Must be proficient in technology, including case management systems, EHR platforms...
workable.com -
San Diego
Establishment and Implementation of Managed Care Two-Plan Model for United Health Centers.
• Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable, follow-up...
icims.com -
Pacific Health Group-San Diego
assessments as needed.
Care Coordination & Community Collaboration
• Collaborate with primary care providers, specialists, behavioral health providers, hospitals, managed care plans, and community organizations.
• Facilitate communication among...
workable.com -
Randstad-San Diego
with a strict requirement for fast-paced hospital or ER department background.
• General knowledge of managed care plans, scheduling logistics, medical billing, and medical terminology.
• strong technical proficiency navigating personal computers, entry...
randstadusa.com -
Pacific Health Group-San Diego
and maintain relationships with healthcare providers, managed care organizations, community-based organizations, educational institutions, workforce development agencies, and strategic partners.
• Represent Pacific Health Group at networking events, conferences...
workable.com -
San Diego
Ability to assist clinical team with discharge planning – identifying and contacting appropriate facilities for transfer of care when needed.
• Knowledge of managed care and insurance- as it relates to mental health benefits- is a plus.
• Outreach...
icims.com -
Pacific Health Group-San Diego
Experience working within Medi-Cal, CalAIM, ECM, Community Supports, Behavioral Health, or managed care environments strongly preferred.
• Strong understanding of outreach operations, member engagement, and relationship-based care models.
• Excellent...
workable.com -
San Diego
as provided by the Managed Care Support Contractor (MCSC).
• Drive Time Mapping. The contractor shall maximize utilization of direct care capacity and will ensure that beneficiaries are scheduled at a SDM MTF within DHA ATC standards as well as drive time...
icims.com -
Pacific Health Group-San Diego
program development
• Engage with Medi-Cal managed care plans, county behavioral health agencies, and payer partners to support network and membership growth
• Collaborate with marketing and communications to ensure consistent, mission-aligned outreach...
workable.com -
San Diego
attorneys, 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...
icims.com -
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