Medicare Jobs in Rancho Cucamonga
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Search Results - Medicare Jobs in Rancho Cucamonga
IEHP-Rancho Cucamonga
but not limited to, Covered California, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC), in addition to collaboration with, inter...
mindmatch.ai -
Alura Workforce Solutions-Rancho Cucamonga
Position
Pharmacy Technician- UM
Location
Rancho Cucamonga, Ca
Description
Input, review and decision Medicare Part B and Medi-Cal requests for J codes, S code, Q codes, B codes and other medical benefits drugs/supplies.
Review Requests based...
resume-library.com -
IEHP-Rancho Cucamonga
Commercial Products, the Director, Product Development will be responsible for developing product portfolios for all IEHP lines of business: Covered California, Medicare Advantage, Dual-eligible Special Needs Plans (D-SNP), and Group products.
This role...
mindmatch.ai -
Alura Workforce Solutions-Rancho Cucamonga
clinical information within compliance turnaround times and quality standards meeting regulatory requirements as defined by Department of Health Care Services, Center for Medicare & Medicaid Services, California Department of Managed Health Care...
resume-library.com -
Rancho Cucamonga
Director of Commercial Products, the Director, Product Implementation - Medicare & Commercial, will lead the annual product renewal and implementation projects to support the Medicare D-SNP and Covered California lines of business.
Key duties include...
icims.com -
Rancho Cucamonga
in a supervisory capacity. Three (3) years experience in a managed care environment. Experienced in benefit and financial matrix interpretation.
Preferred Experience
Experience preferably in an HMO or Managed Care setting. Medicare and/or Medi:Cal experience...
tiptopjob.com -
Rancho Cucamonga
performance management, and forecasting for IEHP’s Medicare and Commercial (i.e., Covered CA) line of business. This includes, but not limited to, the development of product analytics to define and measure the financial performance and providing actuarial...
icims.com -
Rancho Cucamonga
bonus opportunities
Qualifications:
Education & Experience
• Four (4) years claims processing experience including Medicare and Medi-Cal
• Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR...
icims.com -
Rancho Cucamonga
advancement opportunities and professional development
• Competitive salary with annual merit increase
• Team bonus opportunities
Qualifications:
Education & Experience
• Minimum of five (5) years in Medi-Cal and/or Medicare managed care with regulatory...
icims.com -
Rancho Cucamonga
problem solver capable of accomplishing program goals.
• Maintain Member confidentiality.
• Strong knowledge and familiarity with:
• Medi-Cal and Medicare required.
• Resources available in both Riverside and San Bernardino Counties such as housing...
icims.com -
Rancho Cucamonga
operations, processes, procedures, policies, etc. are in compliance with regulatory agencies, including but not limited to, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California...
icims.com -
Rancho Cucamonga
functional business units, Medicare, Medi-Cal, and Covered California lines of business requirements, organizational design, and business process improvement methods. This Manager will work closely with the Provider Network Manager and Credentialing Manager...
icims.com -
Rancho Cucamonga
procedures, policies, etc. are in compliance with regulatory agencies, including but not limited to, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed...
icims.com -
Rancho Cucamonga
and/or respond to regulatory agency reports (Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), etc.), surveys, audits, and evaluations.
22. Any other duties as required...
icims.com -
Rancho Cucamonga
criteria such as Medicare Local Coverage Determination, Medicare National Coverage Determination, Milliman Care Guidelines, InterQual, and Apollo Managed Care Guidelines/Medical Review Criteria
• ICD-10 and CPT coding capitated managed care environment...
icims.com -
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