Personal Care Coordinator (HRA Outreach) (Bilingual in Vietnamese) CalOptima CalOptima Health is seeking a highly motivated an experienced Personal Care Coordinator (HRA Outreach) (Bilingual in Vietnamese) to join our team. The Personal Care Coordinator (HRA Outreach) will support the members in completing their health risk assessment (HRA). The incumbent will ensure communication of the member's HRA and care plan with the member, primary care provider (PCP) and health care team. The incumbent w
Our client is an innovator in providing mid-market ERP solutions along with next-generation technologies that empower companies to achieve their full potential. Specializing in mid-market ERP solutions and expertise across finance, accounting, operations, workforce management, and customer experience, our client serves as a trusted advisor to small and mid-sized companies in a variety of industries across the US. Due to rapid growth, they have engaged us to find a Consulting Manager to lead the
MES Technical Architect Job Location:- Remote MES and Pharma background is mandatory Looking for an MES Technical Architect with 2-5 years as an automation or MES specialist with programming, infrastructure, and system design experience Job Responsibilities: Develop and maintain a standard architecture for MES projects that impact digital application landscape, guide, and help project teams in implementing defined architectures Create and maintain a global qualified environment for proof of c
Two open positions - 100% remote 1) Dell Boomi Architect 2) Dell Boomi Integration Developer With EDI Ideal for candidates who are looking for Part-time roles Job Role: Dell Boomi Architect Location: Remote Duration: 3 Months Hours:(Based on Client requirement) Bachelor s or master s degree in computer science or related engineering field w/experience in software development.15 years of direct experience developing and designing application-level interfaces using a variety of architectures an
Supervisor, Behavioral Health (Utilization Management) CalOptima Health is seeking a highly motivated an experienced Supervisor, Behavioral Health (Utilization Management) to join our team. The Supervisor Behavioral Health (Utilization Management) will be responsible for the daily operation of Behavioral Health Integration (BHI) Utilization Management (UM) functions. The incumbent will oversee the benefit s prior authorization, concurrent review processes and transition of care. The incumbent w
Personal Care Coordinator (HRA Outreach) (Bilingual in Vietnamese) CalOptima CalOptima Health is seeking a highly motivated an experienced Personal Care Coordinator (HRA Outreach) (Bilingual in Vietnamese) to join our team. The Personal Care Coordinator (HRA Outreach) will support the members in completing their health risk assessment (HRA). The incumbent will ensure communication of the member's HRA and care plan with the member, primary care provider (PCP) and health care team. The incumbent w
THIS JOB CAN BE DONE REMOTELY FROM THE US, BUT REQUIRES 50% TRAVEL. IF YOU LIVE OUTSIDE OF THE DC / VA / SURROUNDING AREA THE % OF TRAVEL MAY INCREASE. KORE1, a nationwide provider of staffing and recruiting solutions, has an immediate opening for a Federal Business Development Manager: physical access control product sales to federal agencies The Federal Business Development Manager at plays a pivotal role in driving revenue growth within the Federal Government sector. This position requires a
Care Manager (Transitional Care Services Maternal Health) CalOptima CalOptima Health is seeking a highly motivated an experienced Care Manager (Transitional Care Services Maternal Health) to join our team. Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Health's members. The Care Manager for Transitional Care Services (TCS) Maternal Health will facilitate communication and coordination among all participant
Greetings, This is Radhika from Softpath System LLC. Softpath is a preferred nationwide staffing vendor to Fortune 500 companies in the US. We have an immediate opportunity with one of our clients. Position: SRE w/ PL/SQL scripting (build up code), Python, API, Kafka, AWS experience 6 month + contract REMOTE Candidates need to have experience with Building out SRE maturity Streamlining pipelines Ensuring Clean Code Automation of products Integration Sustainability Minimizing outages Enhancing
Data Analyst, Sr. (HEDIS) CalOptima CalOptima Health is seeking a highly motivated an experienced Data Analyst Sr to join our team. The Data Analyst Sr (HEDIS) will provide expertise in business requirements for the organization's Healthcare Effectiveness Data and Information Set (HEDIS) data reporting and analysis in the Quality Analytics department. The incumbent will be responsible for conducting quality assurance on data collection, data processing, data analysis and reporting. In addition,
Our client is seeking an experienced technical IT Business Analyst tojoin our team in supporting the implementation and management of varioussoftware development projects. Due to the growing demand for IT systems and solutions,client is seeking an experienced technical IT Business Analyst to join our team in supportingthe implementation and management of various software development projects. The successful candidate will have a strong background in Software Development LifeCycle (SDLC) methodol
Project/Program Manager Information Technology Job Description: Project/Program Manager Project/Program Manager Roles and Responsibilities 10 or more years of experience as a project manager Experience in a project management role with leadership responsibilities with multi-year projects Strong knowledge of project management methodologies, tools and phases of the project lifecycle Experience, knowledge and ability to apply change management principles and methodologies to support large, c
Clinical Auditor, Sr. CalOptima CalOptima Health is seeking a highly motivated an experienced Clinical Auditor, Sr. to join our team. The Clinical Auditor Sr will serve as the auditor for clinical and quality areas within the Case Management department. The incumbent will ensure regulatory (Medicare and Medi-Cal including Whole Child) and accreditation National Committee for Quality Assurance (NCQA) compliance for all CalOptima Health lines of business by conducting routine oversight, monitoring
Program Specialist, Int. (Pharmacy Management) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Specialist, Int. to join our team. The Pharmacy Program Specialist Int will handle complex assignments and issues, overseeing and coordinating departmental operations and serving as a reference to other pharmacy employees and as a representative of the Pharmacy Management department within CalOptima Health and with other agencies. Under general supervision, the incumbent
QI Nurse Specialist (LVN) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (LVN) to join our team. The Quality Improvement (QI) Nurse Specialist (LVN) for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's direct network and delegated Health Network teams. The incumbent will be responsible for ensuring standards are met for operational and oversight compliance and UM operations are consistent with regulatory requirements
Claims Recovery Specialist CalOptima CalOptima Health is seeking a highly motivated an experienced Claims Recovery Specialist to join our team. The Claims Recovery Specialist will be responsible for performing recoveries on claims that have been overpaid and must understand and adhere to recovery regulations mandated by CalOptima Health policies, AB1455, Centers for Medicare & Medicaid Services (CMS), Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) regulati
Job title: IT Sales Manager Mode of work: Remote Job Type: Full Time Responsibilities Actively prospect and identify potential new clients in the IT services industry. Develop and deliver sales presentations and proposals. Negotiate and close sales deals, including contract terms and pricing agreements. Identify and develop new business opportunities in the IT services market, with a focus on enterprise software development. Collaborate with technical teams to develop comprehensive proposals an
QI Nurse Specialist (RN) (Utilization Management) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (RN) (Utilization Management) to join our team. The Quality Improvement (QI) Nurse Specialist for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's direct network and delegated Health Network teams. The incumbent will be responsible for ensuring standards are met for operational and oversight compliance and UM operations a
