Program Assistant

3 weeks ago

Orange, United States 9992 Full time
Job DescriptionJob Description

Duties & Responsibilities:

* 80% - Program Support
* Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
* Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
* Serves as the point of contact within or outside CalOptima Health for inquiries related to grievances and appeals.
* Monitors incoming complaints via the Customer Service system routing, interdepartmental referral, mail, telephone, fax or via email from the website for members and providers.
* Monitors inquiry requests from the Department of Managed Health Care (DMHC), Medicare Complaint Tracking Module (CTM) from the Centers for Medicare Medicaid Services (CMS), Medicare Quality Improvement Organization (QIO) and the State Hearing Office from Department of Social Services (DSS).
* Responds to DMHC requests for information in a timely manner.
* Sets up complaint case files, enters cases in the GARS system with accurate classification and category types and assigns them to appropriate staff.

* 15% - Administrative Support
* Works with internal and external departments and providers in gathering supporting information relevant to the case.
* Generates acknowledgment letters for all lines of business per department and regulatory standards.
* Assists in the development of departmental forms and intake processes.
* Coordinates administrative support for state hearings, serves as a contact with DSS for incoming cases, enters cases in the GARS system, creates electronic files and routes the scanned documents to designated staff and fax required state hearing documentation to the local hearing office as necessary.

* 5% - Other
* Completes other projects and duties as assigned.

Minimum Qualifications:

* • High School diploma or equivalent required.
• 1 year of experience in appeal and grievance guidelines or Medi-Cal/Medicaid or Medicare programs required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

* • Bilingual in English and in one of CalOptima Health’s defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).

Knowledge & Abilities:

* Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
* Work independently and exercise sound judgment.
* Communicate clearly and concisely, both orally and in writing.
* Work a flexible schedule; available to participate in evening and weekend events.
* Organize, be analytical, problem-solve and possess project management skills.
* Work in a fast-paced environment and in an efficient manner.
* Manage multiple projects and identify opportunities for internal and external collaboration.
* Motivate and lead multi-program teams and external committees/coalitions.
* Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

* Ability to visually read information from computer screens, forms and other printed materials and information.
* Ability to speak (enunciate) clearly in conversation and general communication.
* Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
* Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
 

  • Program Assistant

    4 weeks ago

    West Orange, United States Transportation Security Administration Full time

    Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-stakes environment to safeguard the American way of life. In cities across the country, you would secure airports, seaports, railroads, highways, and/or public transit systems, thus protecting America's transportation infrastructure...

  • Assistant Program Coordinator

    1 month ago

    Orange Park, United States NEEDS Center Full time

    Job DescriptionJob DescriptionSalary: $17 an hourCOME GROW WITH US! The NEEDS Center is hiring Full Time Assistant Program Coordinator in one of our Orange Park, FL residential homes! Hourly rate is $17 an hour.NEEDS Center’s mission is to provide education, training, and support to individuals with developmental disabilities to assist them to live as...

  • Program Coordinator

    4 weeks ago

    Orange, United States Green solutions Full time

    **Duties & Responsibilities**: - 85% - Program Support - Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. - Assists the team in carrying out department responsibilities and collaborates with others to support short - and long-term goals/priorities for the...

  • Specialist Outpatient Program

    5 days ago

    Orange, United States Alta Hospitals Full time

    Job Summary: The Outpatient Program Specialist will work with Prospects Outpatient Program Leadership and be responsible for assisting with the coordination and/or completion of activities within Outpatient Programs. Responsibilities includes but are not limited to the following: supporting the department team leads on implementing process improvement...

  • Calworks Behavioral Health Services Program

    1 month ago

    Orange, United States Mariposa Women & Family Center Full time

    **Title**: Program Administrator **Classification**: Full time; Exempt **Location**: Orange & San Juan Capistrano **Reports To**: CalWORKs Program Director **Department**: CalWORKS Behavioral Health **Mariposa CalWORKs Behavioral Health Services Program provides culturally competent outpatient behavioral health services and psycho-education to...

  • Benefit Programs Specialist I/II

    2 weeks ago

    Orange, United States State of Virginia Full time

    Hiring Range: $34,752.00 to $52,000.00 Full Time or Part Time: Full Time Additional Detail Title Description- Benefit Programs Specialist I represents the entry level in the occupational group for employees working under close supervision while being trained in determining eligibility for a variety of social services government assistance programs. Upon...

  • ABA Program Supervisor

    2 weeks ago

    Orange, United States Accel Therapies Full time

    Job DescriptionJob DescriptionAbout Accel TherapiesAt Accel Therapies we specialize in Applied Behavior Analysis (ABA) and other therapies. We provide best-in-class, evidence-based treatment programs for children with autism and other developmental needs within a comfortable, positive, and family-oriented environment. What sets us apart is our focus on an...

  • Manager - Programs/projects

    5 days ago

    Orange, United States Avangrid Full time

    Location: Orange CT The base salary range for this position is dependent upon experience and location, ranging from $92,000- $115,000 The Manager - Programs/ Project position will act as a project manager to manage training and other project matters for the UI Electric System Substation Operations Department. The Workforce Training position applies skills...

  • Manager, Population Health Programs

    3 days ago

    Orange, United States Alta Hospitals Full time

    The Manager of Population Health Programs (PHP) is responsible for managing, organizing, and coordinating Prospects Population Health Program activities. An in-depth understanding of managed care, Medicare and Medicaid regulations, Model of Care and NCQA Population Health requirements are necessary. The Manager of PHP will have staff oversight including...

  • Residential Assistant

    2 weeks ago

    Orange, United States YCS Full time

    The YCS Sawtelle Lawnridge Program in Orange, NJ provides intensive behavioral interventions for children, ages 5-21, with developmental and intellectual disabilities (including autism and co-occurring behavioral and/or mental health challenges in a natural, home-like setting. The program is currently hiring for Residential Assistants. Residential Assistants...

  • Medical Assistant

    1 month ago

    Orange, United States Cancer and Blood Specialty Clinic Full time

    **JOB PURPOSE** The job purpose of a Medical Assistant at the Cancer and Blood Specialty Clinic is to provide exceptional patient care and support to medical professionals in the clinic. This role involves assisting with various medical procedures, performing administrative tasks, and ensuring a smooth workflow within the clinic. **ESSENTIAL JOB...

  • Sr Administrative Assistant

    4 weeks ago

    Orange, United States Chapman University Full time

    Job DescriptionJob DescriptionReporting to the Chairs of Biomedical and Pharmaceutical Sciences (BPS) and Pharmaceutical Economics and Policy (PEP), the incumbent will provide administrative support to the department chairs, faculty, research staff, and graduate students. Manage department office and oversee workflow. Maintain and submit records for the use...

  • Graduate Assistant

    2 weeks ago

    Orange, United States Seton Hall University Full time

    Graduate Assistant - EOP 2024/2025Job no: 496301 Full time/Part time: Part-time Location: South Orange Categories: Graduate AssistantDuties and Responsibilities:Graduate student will provide administrative support in the areas of enrollment services, academic advising, student programming, and/or academic support services. Responsibilities can include...

  • Medical Assistant

    4 weeks ago

    Orange, United States Medi-Weightloss Full time

    Job DescriptionJob DescriptionPosition: Medical Assistant Company: Medi-Weightloss of OrangeLocation: Orange, CTSchedule: Part-TimeAbout Us: Join our thriving team at Medi-Weightloss of Orange,CT where we're dedicated to transforming lives by helping individuals achieve their health and weight loss goals. Our personalized medical weight loss programs,...

  • Mediation Clinic Data Assistant

    4 weeks ago

    Orange, United States Chapman University Full time

    Job DescriptionJob DescriptionChapman University has been awarded grant funds to provide the Riverside Probation Department a 3-pronged approach to the Pathways to Success program for juveniles/youth. This position is responsible for statistical analysis of quantitative and qualitative data to assist the Co-Director with assessing the metrics required to...

  • Commercial Insurance Assistant

    5 days ago

    Orange, United States Petra Risk Solutions Full time

    Job Description Petra Risk Solutions is currently looking for Commercial Insurance Assistants who are licensed by the California Department of Insurance. Experience with Commercial Insurance coverage is preferred. This position is for full time, regular employment. Typical duties for this position include: Complete policy application forms Assist in...

  • Medical Office Assistant

    2 weeks ago

    Orange, United States PRIDE Health Full time

    Medical Office Assistant Pride Health is hiring a Medical Office Assistant for one of its clients in California. This is an 8-week contract with a possible extension with competitive pay and benefits. Location Orange, California 92868 Length of assignment 8 weeks Pay range - $18 - $22 per hour. Shift and Schedule Mon - Fri - 08:00 AM - 04:30 PM Job...

  • Commercial Insurance Assistant

    4 weeks ago

    Orange, United States Petra Risk Solutions Full time

    Job DescriptionJob DescriptionPetra Risk Solutions is currently looking for Commercial Insurance Assistants who are licensed by the California Department of Insurance. Experience with Commercial Insurance coverage is preferred. This position is for full time, regular employment.Typical duties for this position include:Complete policy application formsAssist...

  • Caregiver/personal Assistant

    3 days ago

    Orange, United States Homewatch CareGivers Full time

    Job Summary: We are seeking dedicated and compassionate Caregivers to provide support and assistance to individuals in need. As a Caregiver, you will play a crucial role in ensuring the well-being and comfort of our clients. This position requires a strong background in home care, patient care, senior care, direct support, behavior management and...

  • Estimating Executive Assistant

    1 month ago

    Orange, United States Marina Landscape Full time

    **_Job Description: Estimating Executive Assistant_** **_ CLASSIFICATION PURPOSE_** This exempt supervisory position is responsible for ensuring the efficient operation of various administrative functions including executive-level support, office procedures, and program maintenance; perform related work as required. **_ ESSENTIAL FUNCTIONS_** - The...