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Central California Alliance for Health

Related companies:

🏢 Central California Alliance for Health (Remote)
🏢 Owlet Baby Care, Inc.
🏢 EMC_Careers

Jobs at this company:

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🔥 Temporary Senior Enhanced Care Management Advisor (RN)
Posted 2024-10-18

đź“Ť California

🧭 Temporary

đź’¸ 50 - 62 USD per hour

🔍 Healthcare

  • Current unrestricted license as a Registered Nurse issued by the state of California.
  • Associate’s degree in Nursing and a minimum of seven years of experience in relevant healthcare fields.
  • Bachelor’s degree may substitute for two years of required experience.
  • Knowledge in community-based nursing, service delivery, case management, and evidence-based care guidelines.

  • Act as a liaison between the ECM/CS Program and providers/community agencies to promote effective implementation.
  • Perform ECM/CS Program oversight and support activities.
  • Support Provider Services Department with training ECM/CS providers.
  • Develop and manage individualized comprehensive care plans for members in the ECM Program.
  • Educate members, families, providers, and agencies about the Case Management Program.

LeadershipData AnalysisPeople ManagementCross-functional Team LeadershipData analysisCommunication SkillsAnalytical SkillsCollaboration

Posted 2024-10-18
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🔥 Temporary Senior Complex Case Manager (Adult or Peds, Remote in California)
Posted 2024-10-18

đź“Ť California

🧭 Temporary

🔍 Healthcare

  • Must have a current and unrestricted Registered Nurse license issued by the State of California.
  • Required to have an Associate's degree in Nursing.
  • A minimum of five years of nursing experience is necessary.

  • Coordinate care and empower members to achieve health goals through collaboration with community providers.
  • Develop and manage comprehensive care plans for members referred into the Case Management Program.
  • Support children and families through assessment of needs and development of member-centric care goals.

Communication SkillsAnalytical SkillsCollaboration

Posted 2024-10-18
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🔥 Lead Payer Analytics Consultant
Posted 2024-10-18

đź“Ť California

🧭 Full-Time

đź’¸ 123595 - 179962 USD per year

🔍 Healthcare

  • Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or related field.
  • A minimum of eight years of experience in financial healthcare reimbursement analysis (a Master’s degree may substitute for two years).
  • Knowledge of financial modeling techniques, provider reimbursement methodologies, healthcare data structures, accounting principles, and statistical analysis.

  • Functions as a strategic consultant to Alliance executive leadership in complex managed care payer financial modeling and statistical analysis.
  • Advises on decision-making through complex financial analysis to support successful payer reimbursement outcomes.
  • Acts as a subject matter expert, collaborating with stakeholders to achieve payer reimbursement objectives.
  • Leads subordinate staff.

LeadershipData AnalysisPeople ManagementCross-functional Team LeadershipStrategyFinancial ManagementData analysisCommunication SkillsAnalytical SkillsCollaborationMicrosoft Excel

Posted 2024-10-18
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🔥 Temporary Claims Technician II
Posted 2024-10-13

đź“Ť California

🧭 Temporary

đź’¸ $24 - $27 per hour

🔍 Healthcare

  • Knowledge of: Medical insurance Explanation of Benefits.
  • General office equipment, including personal computer, telephone, photocopier, fax, etc.
  • Windows-based PC systems, including Microsoft Word, Excel, and Outlook.
  • Ability to: Understand current software programs and screens that are required in the daily processing of claims.
  • Keep current on claims processing practices and procedures.
  • Education and Experience: High school diploma or equivalent and two years (or an Associate’s degree and a minimum of one/two years) of relevant experience with claims processing in an automated claim environment; or a combination of education and relevant experience may be qualifying.

  • Reporting to the Claims Supervisor you will: Verify, process, and/or adjudicate claims, including applying detailed consideration, standards in pending and releasing claims from pend edits and for proper application of program policy related to claim entry and analysis.
  • Assists with training new hires and cross-training other Claims Technicians.

Communication SkillsAnalytical SkillsCollaborationMicrosoft Excel

Posted 2024-10-13
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