Claims Resolution Specialist (Customer Service) CalOptima Join Us in this Amazing Opportunity The Team You'll... of contact for CalOptima Health providers. You will assist providers with questions related to the payment of claims...
Grievance & Appeals Nurse Specialist CalOptima Join Us in this Amazing Opportunity The Team You'll... in managing CalOptima Health's medical appeals and state hearing reviews for all lines of business, including handling expedited...
Regulatory and Contract Compliance Specialist (Contracts Specialist Sr) CalOptima Join Us in this Amazing... to this Role: Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership...
Program Manager, Broker Management CalOptima Join Us in this Amazing Opportunity The Team You'll... with department goals and CalOptima Health's strategic priorities. Makes moderate to significant improvements of processes...
Auditor, Provider Data CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission... for conducting ongoing data quality auditing of CalOptima Health's provider network data, which includes working with internal...
Enterprise Release & Environment Architect (ITS Architect IV) CalOptima Join Us in this Amazing Opportunity The... CalOptima Health organization. The primary responsibility of this role is to plan, schedule, and coordinate software releases...
Program Manager (Provider Data Operations) CalOptima Join Us in this Amazing Opportunity The Team You'll... and market trends that may impact CalOptima Health's provider programs and/or mission. 5% - Completes other projects...
Program Manager (Provider Relations) Job Description Why CalOptima? CalOptima is the single largest health plan... you to join CalOptima. Job Summary The Program Manager leads the development and implementation of special projects, programs and new...
experience preferred General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi...
as needed. Qualifications At least two years medical back office experience. Knowledge of insurance groups e.g. Medi-Cal, CalOptima, Medicare...