required by the member. The Community Supports (CS) Nurse processses clinical, psychsocial and social determinants of health... records of services for medical necessity Consultation with the Alliance Medical Director to validate patient acuity and plan...
services for health plan members with highly complex medical and psychiatric conditions where advocacy and coordination... comprised of the Health Navigators and external ECM Providers in the community. This collaborate team approach to case...
, coordination, and monitoring of compliance activities within the managed care health plan. The role involves collecting... and building comprehensive reports that reflect the health plan's compliance status and communicating with delegates and external...
experience) Familiarity with managed care and publicly funded health programs (Medicare, Medi- Cal) MINIMUM YEARS... RANGE $92,051.06 - $138,076.59 ANNUALLY The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications...
A-Line is now hiring a Hybrid - Grievance and Appeal Coordinator in Alameda, CA. Grievance and Appeal Coordinator in... and prepare the Alliance component of the State Fair Hearing, MAXIMUS, Independent Medical Review (IMR), and DMHC appeal processes...
, and Registration with CAQH. Paneled with Alameda Alliance is a plus. (non-licensed clinicians maybe considered depending on the... OR CLOSELY LICENSED CA BBS Registered mental health therapist to join a growing group private practice in Dublin, CA. Medical...
. JOB DESCRIPTION: About Abbott Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re... for employees* via the Health Investment Plan (HIP) PPO An excellent retirement savings plan with high employer contribution...