, Department of Health Care Services Medi-Cal Managed Care Accountability Set, and Department of Managed Health Care (DMHC) Health... OR TRAINING EQUIVALENT TO: · Master's degree in a health care field (i.e. nursing, health sciences/administration) strongly...
coordination to assure integration of all Health Care Services department operations. The Manager is responsible for policy... on utilization, health outcomes, care coordination and expenses with comparison to state and national standards and benchmarks...
. 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...
, 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...
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...
, 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...
. 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...