Overview: To oversee the appropriateness and quality of care delivered through PartnershipHealthPlan of California..., in State Fair Hearings. * Engagement of the Partnership provider network to improve quality of care and member experience...
and maintenance. Responsibilities: - Manage the daily functions of the Systems and Data staff and monitor use of Partnership systems... and participate in selection of PR staff that are direct reports. - Participate in preparation and interview process for Partnership...
or equivalent. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy... ability to lift, carry, or move objects of varying size, weighing up to 35 lbs. All HealthPlan employees are expected...
as assigned. Qualifications: Education and Experience Minimum three (3) years claims examining experience;or Partnership... coding. Knowledge of Partnership Claim Policy and Procedures, EDS provider manual guidelines, Title 22 regulations...
. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy.... Manages work flow and process reengineering efforts as required. Develops strategies and schedules for meeting Partnership...
, Visio, and PowerPoint. Valid California driver’s license and proof of current automobile insurance compliant... with Partnership policy are required to operate a vehicle and travel for company business. . Performance Based Competencies...
a review of all relevant medical records. * Obtain responses from provider(s) and appropriate Partnership departments. When... activities as determined by the Peer Review Committee or Partnership policy. * Generates a request for a Corrective Action Plan...
with understanding PartnershipHealthPlan of California's policies and procedures and assists with resolving issues that arise... for research and entry of information. Valid California driver’s license and proof of current automobile insurance compliant...
Team and is responsible for leading a growing Quality Department at PartnershipHealthPlan of California (PHC) through...’s Partnership Improvement Academy, DCHS mandated improvement work, performance improvement and engagement activities done with the...
of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level... HealthPlan’s policies and procedures, as they may from time to time be updated. HIRING RANGE $27.56 - $32.38 IMPORTANT...