for the planning, implementation, strategic oversight, and overall operations of AlamedaAlliance for Health's Medicare... and implement Star strategies for AlamedaAlliance for Health's Medicare Advantage D-SNP product, ensuring alignment...
to other Alliance departments and staff (Contracting, Health Care Services, Provider Services, Senior Staff, Medical Director..., and maintaining the credentialing and recredentialing processes of health care providers and practitioners to ensure they meet the...
to members, providers and regulatory agencies. Interprets and explains health plan benefits, policies, procedures, and functions.../grievance record in the electronic database. Coordinate and prepare the Alliance component of the State Fair Hearing, MAXIMUS...
will provide case management services for health plan members with highly complex medical and psychiatric conditions where advocacy... will be working closely with a team comprised of the Complex Case Manager Nurse, a Medical Social Worker and a Health Navigator...