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Care Manager (Transitional Care Services Maternal Health)

CalOptima

•

Remote

Full-time

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
Posted 10 days ago

Actuary Principal

CalOptima

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Orange, California, USA

Full-time

Actuary Principal CalOptima CalOptima Health is seeking a highly motivated an experienced Actuary Principal to join our team. The Actuary Principal is a key member of the Financial Analysis department. The incumbent is responsible for rendering actuarial analysis and pro-active recommendations to management on both tactical and strategic nature. In addition, the incumbent collaborates with members from business units across the organization and provide actuarial services that enable actionable i
Posted 7 days ago

Financial Analyst III

CalOptima

•

Orange, California, USA

Full-time

Financial Analyst CalOptima CalOptima Health is seeking a highly motivated an experienced Financial Analyst to join our team. The Financial Analyst will be responsible for providing quantitative financial analysis for various departments within CalOptima Health. Under limited to no supervision, the incumbent will develop report suites and financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, partic
Posted 10 days ago

Program Manager (Equity & Community Health)

CalOptima

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Orange, California, USA

Full-time

Program Manager (Equity & Community Health) CalOptima CalOptima Health is seeking a highly motivated an experienced Program Manager to join our team. The Program Manager (PM) Equity and Community Health (ECH) Strategic Initiatives plays a vital role in the program design, development, implementation and support of ECH initiatives, pilots and programs related to the National Committee for Quality Assurance (NCQA) Health Plan and Health Equity Accreditations, Department of Health Care Services (DH
Posted 10 days ago

Community Relations Specialist, Sr.

CalOptima

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Orange, California, USA

Full-time

Community Relations Specialist, Sr. CalOptima CalOptima Health is seeking a highly motivated an experienced Community Relations Specialist, Sr. to join our team. The Community Relations Specialist Sr will represent CalOptima Health in the community and to community-based organizations. The incumbent will be responsible for planning and coordinating community outreach activities, including quarterly networking forums, community town hall meetings, stakeholder meetings/educational seminars and hea
Posted 10 days ago

Program Manager (Behavioral Health)

CalOptima

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Remote

Full-time

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
Posted 31 days ago

Contracts Manager

CalOptima

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Orange, California, USA

Full-time

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
Posted 31 days ago

Customer Service Representative

Tranzeal, Inc.

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Englewood, Colorado, USA

Contract

Job Title: Customer Service Representative Location: Englewood, CO- (Hybrid) ESSENTIAL DUTIES AND RESPONSIBILITIES: Respond to inbound calls, emails, and faxes promptly and courteously.Handle placement requests and inquiries via outbound calls and emails.Coordinate patient placements with hospitals.Exhibit excellent customer relationship skills and empathize under stress.Manage time effectively, prioritize tasks, and ensure accuracy.Add knowledge to CRM databases to improve processes.Use resourc
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Posted 2 days ago

Clinical Auditor, Sr.

CalOptima

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Remote

Full-time

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
Posted 7 days ago

Technical Writer

Sunrise Systems, Inc.

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Bothell, Washington, USA

Contract

Sunrise System Inc. is currently looking for Technical Writer in Bothell, WA with one of our top client. Job Title: Technical Writer Job Id: 24-00408 Location: Bothell, WA 98021 Duration: 12 months Position Type: Hourly contract Position (W2 only) TOP SKILLS: Minimum of 5-8 years experience in a GMP laboratory environment. At least 5 years experience in writing and reviewing standard operating procedures.Experience with Veeva EDMS preferred, or similarExperience with ERP, SAP Preferred, revis
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Posted 60+ days ago | Updated 16 days ago

Office Apps Developer

JDA TSG

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Remote

Full-time

We have immediate opportunities for US based Office Apps Developer to join our team working as Customer Engineers (CE s). Positions are full time, salaried roles offering comprehensive benefits. A CE s time is dedicated to working with some of the largest, and most sophisticated companies in the world, usually F1000 companies. CE s support and assist customers in building, deploying, operating and optimizing complex enterprise environments. You will be responsible for customer satisfaction, depl
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Posted 3 days ago

Power Apps Support- Part Time

MSYS Inc.

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Remote

Contract

Title: Power Apps Support- Part Time Location: Remote Length: Long term Restriction: W2 or C2C Description: Webcam interview long term project initial PO for 1 year with multiyear extensions Remote Part-Time about 20 hours per week Need 3 references Description: Provide Power Apps contract support to help maintain existing Power Apps Applications and develop new Power Apps as needed. Scope of Work The tracking developed in Power Apps will need contractor support to help maintain the existing wo
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Posted 1 day ago

Program Manager

CalOptima

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Orange, California, USA

Full-time

Program Manager CalOptima CalOptima Health is seeking a highly motivated an experienced Program Manager to join our team. Under the general direction of the Director, the Program Manager (Quality Analytics (CMS Stars)) will collaborate and coordinate with leadership to design, implement and evaluate quality programs for the Centers for Medicare & Medicaid Services (CMS) Star Ratings and other similar quality programs. The incumbent will lead, coordinate, monitor and complete tasks supporting the
Posted 10 days ago

Chief Administrative Officer

CalOptima

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Orange, California, USA

Full-time

Chief Administrative Officer CalOptima CalOptima Health is seeking a highly motivated an experienced Chief Administrative Officer to join our team. As a member of the executive team, the Chief Administrative Officer (CAO) has overall responsibility and accountability for the activities of the Clerk of the Board, Communications & Marketing, Government Affairs, Strategic Development, and Enterprise Project Management. The CAO creates a shared sense of purpose to achieve an aligned mission and visi
Posted 10 days ago

Global Trainer EcoStruxure Automation Expert

Net2Source Inc.

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Andover, Massachusetts, USA

Full-time

Role: Global Trainer EcoStruxure Automation Expert Location: Andover MA// onsite Hire Type: Fulltime - Permanent Description Job summary Join the team of trainers to deliver the technical training of Eco Struxure Automation Expert our next generation industrial automation system and supported technologies. Required Skills- Proven experience in the Industrial Automation sector, with focus on Automation Systems including PLC/Client/SCADA portfolios (software & hardware). Knowledge of fieldbus
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Posted 60+ days ago | Updated 5 hours ago

Patient Resources Representative

Tranzeal, Inc.

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Remote

Contract

Job Title: Sr. Patient Resources Representative Location: Irvine, CA / Denver, CO / REMOTENeed Spanish speakers Qualifications: Required:o Highschool Diploma or equivalent o Healthcare and medical billing/collections/denial remediation experience o Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook Preferred:o Associates or Bachelor's degree o Demonstrated history of resolving challenging issues o Ability to research and problem solve, using analy
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Posted 1 day ago

QI Nurse Specialist (LVN)

CalOptima

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Remote

Full-time

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
Posted 7 days ago

Claims Recovery Specialist

CalOptima

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Remote

Full-time

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
Posted 10 days ago

QI Nurse Specialist (RN) (Utilization Management)

CalOptima

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Remote

Full-time

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
Posted 10 days ago

Network Administrator (ITS Administrator Sr)

CalOptima

•

Orange, California, USA

Full-time

Network Administrator (ITS Administrator Sr) CalOptima CalOptima Health is seeking a highly motivated an experienced Network Administrator (ITS Administrator, Sr.) to join our team. The Network Administrator (ITS Administrator, Sr.) will be responsible for the day-to-day administration of CalOptima Health's multi-platform network environment. The incumbent will support Microsoft Azure, Extreme Networks, F5 Networks, Palo Alto Networks, RSA Security, Pulse Secure and Zscaler systems. The incumben
Posted 9 days ago