Contracts Manager CalOptima CalOptima Health is seeking a highly motivated an experienced Contracts Manager to join our team. The Contract Manager will be responsible for the developing, maintaining and negotiating contracts with county and third-party providers and professional and ancillary providers, including the ongoing management of Letters of Agreement. The incumbent will participate in network development, physician recruitment, rate proposal analyses and present proposals to the Contrac
QI Nurse Specialist (Facility Site Review Nurse Auditor) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist to join our team. The QI Nurse Specialist (Facility Site Review Nurse Auditor) will be responsible for performing Department of Health Care Services (DHCS), Facility Site Reviews (FSR) and Medical Record Review (MRR) in compliance with DHCS Medi-Cal Managed Care Division (MMCD). The incumbent will be responsible for auditing health network, CalOptim
Medical Case Manager (LVN) (Concurrent Review) Job Description Department(s): Utilization Management (Concurrent Review) Reports to: Supervisor, Utilization Management (Concurrent Review) FLSA status: Non-Exempt Salary Grade: K - $70,000 - $114,268 Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Thursday, February 15, 2024 at 11:59 PM. Applicants are encouraged to a
Program Specialist Sr CalOptima CalOptima Health is seeking a highly motivated an experienced Program Specialist Sr to join our team. The Program Specialist Sr (Medi-Cal and CalAIM) will be responsible for supporting various projects related to Medi-Cal and the Department of Health Care Services (DHCS) California Advancing and Innovating Medi-Cal (CalAIM) initiatives and assist in daily operations of services. The incumbent will plan, analyze, research and coordinate Medi-Cal and CalAIM projects
Manager Case Management CalOptima CalOptima Health is seeking a highly motivated an experienced Manager Case Management to join our team. The Manager Case Management provides shared responsibility for the daily operations, activities and projects for the Case Management department. The incumbent works under the general direction of the Director of Case Management and in partnership with the other department managers to provide performance management and development of the case management staff a
Program Specialist (BHI) Job Description Department(s): Behavioral Health Integration Reports to: Manager Behavioral Health FLSA status: Non-Exempt Salary Grade: E - $48,000 - $72,292 Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Thursday, March 14, 2024 at 11:59 PM. Applicants are encouraged to apply early. Applicants that apply after the first review are not gua
Social Worker (Care Manager) (MSSP) CalOptima CalOptima Health is seeking a highly motivated an experienced Social Worker (Care Manager) (MSSP) to join our team. This Social Worker (Care Manager) will assess prospective members for the various programs available. The incumbent will be responsible for developing, implementing, monitoring, modifying and documenting care plans. The incumbent will accept referrals for case management and will make recommendations for the appropriate level of care an
Customer Service Rep - Lead (Bilingual) CalOptima CalOptima Health is seeking a highly motivated an experienced Customer Service Rep - Lead (Bilingual) to join our team. The Customer Service Rep - Lead will provide services to CalOptima Health members and providers. The incumbent will assist members and providers with questions related to the Medi-Cal and OneCare programs for Orange County. The incumbent will provide information regarding eligibility, enrollment and benefits to CalOptima Health
Administrative Assistant (Street Medicine) CalOptima CalOptima Health is seeking a highly motivated an experienced Administrative Assistant (Street Medicine) to join our team. The Administrative Assistant (Street Medicine) will play a crucial role in supporting the effective operation of CalOptima Health's Street Medicine Program by providing administrative and logistical assistance. The incumbent requires a combination of organizational skills, compassion, and the ability to work in a dynamic a
About Rivian Rivian is on a mission to keep the world adventurous forever. This goes for the emissions-free Electric Adventure Vehicles we build, and the curious, courageous souls we seek to attract. As a company, we constantly challenge what's possible, never simply accepting what has always been done. We reframe old problems, seek new solutions and operate comfortably in areas that are unknown. Our backgrounds are diverse, but our team shares a love of the outdoors and a desire to protect it
Program Manager (Behavioral Health) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Manager (Behavioral Health) to join our team. The Program Manager (PM) plays a vital role in the program design, development and implementation of behavioral health (BH) related programs and initiatives. The incumbent works under the general direction of the Manager, Behavioral Health in collaboration with other Behavioral Health Integration (BHI) department leadership to design, i
Program Specialist (Case Management) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Specialist (Case Management) to join our team. The Program Specialist (Case Management) will support various projects and initiatives, as well as assist in the coordination of key strategies to effectively enhance the delivery of Case Management (CM) services. The incumbent will participate in and support CM meetings, activities and projects focused on implementing targeted qualit
Program Manager (Real Estate and Grant Management) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Manager (Real Estate and Grant Management) to join our team. The Program Manager for Real Estate and Grant Management is responsible for supporting and tracking oversight of CalOptima Health's real estate initiatives throughout the project lifecycle. The incumbent will codify, track and report on all housing and building initiatives and projects that are partially or
Registered Dietitian (PACE) Job Description Department(s): Program for All-Inclusive Care for the Elderly (PACE) Reports to: Supervisor Dietary Services (PACE) FLSA status: Non-Exempt Salary Grade: K - $70,000 - $117,268 Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Thursday, March 14, 2024 at 11:59 PM. Applicants are encouraged to apply early. Applicants that app
Supervisor Long Term Support Services CalOptima CalOptima Health is seeking a highly motivated an experienced Supervisor Long Term Support Services to join our team. The Supervisor, Long Term Support Services will be responsible for planning, organizing, developing and implementing the principles, programs, policies and procedures employed in the delivery of Long Term Services and Supports (LTSS) to members in the community and institutionalized settings. The incumbent will be responsible for th
Supervisor, Finance (Budget) CalOptima CalOptima Health is seeking a highly motivated an experienced Supervisor, Finance (Budget) to join our team. The Supervisor Finance (Budget) will be responsible for overseeing the development and management of CalOptima Health's annual budget process planning related to general and administrative, medical management and capital budgets. The incumbent will measure and track departmental expenditures against the budget and provide insights on monthly and quar
Accounting Clerk, Sr. CalOptima CalOptima Health is seeking a highly motivated an experienced Accounting Clerk, Sr. to join our team. Under general direction, the Accounting Clerk Sr will be responsible for performing general accounting and administrative support duties for various specialties including accounts payable (A/P) and account reconciliations. The incumbent will coordinate work with external vendors and various departments within CalOptima Health to ensure that payments are processed
Sr. Manager, Utilization Management (Sr. Manager II) CalOptima CalOptima Health is seeking a highly motivated an experienced Sr. Manager, Utilization Management (Sr. Manager II) to join our team. The Sr Manager II (Utilization Management) will be responsible for providing oversight of clinical team treatment authorization compliance and oversight of internal and external health network partners. The incumbent will lead inventory management process improvements for all clinical operation Utilizat
About Rivian Rivian is on a mission to keep the world adventurous forever. This goes for the emissions-free Electric Adventure Vehicles we build, and the curious, courageous souls we seek to attract. As a company, we constantly challenge what's possible, never simply accepting what has always been done. We reframe old problems, seek new solutions and operate comfortably in areas that are unknown. Our backgrounds are diverse, but our team shares a love of the outdoors and a desire to protect it
Auditor (Claims) Job Description Department(s): Delegation Oversight Reports to: Manager Audit & Oversight (Delegation) FLSA status: Non-Exempt Salary Grade: I - $61,000 - $99,110 Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Monday, February 12, 2024 at 11:59 PM. Applicants are encouraged to apply early. Applicants that apply after the first review are not guaran
