Behavioral Health Utilization Management Medical Case Manager CalOptima Join Us in this Amazing Opportunity The.... You will be responsible for prior authorizations, concurrent review and related processes. You will utilize CalOptima Health's medical...
Program Specialist, Community Relations CalOptima Join Us in this Amazing Opportunity The Team You'll.... You will work closely with the department manager to support CalOptima Health initiatives through community engagement, program...
Program Assistant, Grievance & Appeals CalOptima Join Us in this Amazing Opportunity The Team You'll.../priorities for the department. Serves as the point of contact within or outside CalOptima Health for inquiries related...
Intern, Leave of Absence, Workers Compensation and Accommodations CalOptima Join Us in this Amazing Opportunity... working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse...
and experienced Medical Case Manager on behalf of CalOptima Health to join the Behavioral Health Utilization Management (BHI - BH...
experience preferred General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima preferred Bi...
. Responsibilities Verify insurance (PPO & Medi-Cal: Denti-Cal, IEHP, Molina, CalOptima) Submit claims with proper documentation...
database (HMIS, CES System, WellSky, and CalOptima) in a timely manner (as each database requires). Exit guests from case load... and internal/external database, close out guests’ physical files. Accuracy of CalOptima (CalAIM) billing process submission...
of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English/Spanish, or English/Vietnamese...
Strong customer service skills General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi...