, Medicare and Medi-Cal benefits to specific patient situations. Participates in Utilization Management/Quality Assurance...
auditing. Maintain current knowledge of Partnership Claims Policy and Procedures for all lines of business, Medi-Cal Provider...
settings. This position is focused on supporting progress with an initiative to leverage new Medi-Cal benefits to implement... expansion of early childhood/family integrated behavioral health services into Medi-Cal serving pediatric primary care settings...
. Previous experience with a health plan. Skills Required: Knowledge of managed care and an understanding of Medi-Cal...
with legal requirements per Los Angeles, Cal. Muni. Code 189.04 and the San Francisco Fair Chance Ordinance. For additional state...
experience Bachelor's or other in related field Second language in Spanish Knowledge of Medicare, Medi-Cal, private insurance...
and close-out activities. Experience in safety construction protocols, Cal OSHA requirements and environmental procedures...
. Preferred Qualifications: Experience with working in the County of San Diego Behavioral Health System Knowledge of Medi-Cal...
initiatives that support our product lines: PASC SEIU, Medi-Cal, Medicare and Covered California Marketplace. As a recognized... for all lines of business, including Medi-Cal, Medicare Advantage, and Covered California IFP plans. Partner with Marketing...
and coordinates Medi-Cal (TARS) for presentation to on-site reviewer and files them accordingly or as per facility’s procedure...