, and collaborating with other departments to ensure the Alliance's business, operating and reporting goals are met. Other principal... Services, Grievance and Appeals and other Departments as needed. Provide advice to other Alliance departments on claims...
in collaboration with their team members and other AlamedaAlliance for Health (AAH) department personnel to develop and execute... by the sales department or any of the Alliance's other departments. Consistently evaluate their activities in relationship...
and training.Prepares and participates in Health Plan Audits, provides recommendations for Corrective Action Plans from state... with others in UM, Pharmacy, QI, and Health Education to ensure overall optimal performance of the Health Care Services departments. Participate...
, maintenance and implementation of P&Ps, workflow and training. Prepares and participates in Health Plan Audits, provides... participate in intradepartmental management team meetings. Strategize with others in UM, Pharmacy, QI, and Health Education...
and explains health plan benefits, policies, procedures, and functions to members and providers both verbally and in writing... and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC appeal processes...
and regulatory agencies. Interprets and explains health plan benefits, policies, procedures, and functions to members and providers... in the electronic database. Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent...
. Interprets and explains health plan benefits, policies, procedures, and functions to members and providers both verbally.... Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC...
. Interprets and explains health plan benefits, policies, procedures, and functions to members and providers both verbally.... Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC...
, manage, and document telephone calls, emails, and other sources of contacts from members, and providers, and explain health..., and PowerPoint;andExcellent verbal and written communication skills a must. SALARY RANGE: $27.11- $40.66 Hourly The Alliance...
, and providers, and explain health plan benefits and plan rules. Provide clarification about issues regarding patient and physician... skills a must. SALARY RANGE: $27.11- $40.66 Hourly The Alliance is an equal opportunity employer and makes employment...