US Reimbursement Director

Job DescriptionThe Medical Director of Risk Adjustment is responsible and accountable for the performance of a specific region in terms of RAF score for all product lines that risk adjust and quality scores for all product lines. The Medical Director will be working with internal staff, larger and exclusive PCPs, and CFO to ensure performance of the assigned...

Gold's Gym SoCal Group is looking for passionate individuals to fill our Corporate Sales Director role, this is an exciting opportunity in one of the fastest growing industries in the US - Corporate Health & Wellness. We are the largest Gold's Gym franchise in California, and fastest growing in the nation. Are you good on the phones? Do you love to close...

Careers That Change Lives The Product Development Program Director ensures best-in-class new product development practices as a competitive advantage for the business. The Program Director will lead and direct day to day activities for core team members through managing project plans, issues tracking, and accountability for deliverables across multiple...

Job DescriptionEssential Duties Responsibilities include the following :Works collaboratively with campus medical directors, managers and staff working in concurrent review/Vital Care management/Prior Authorization Departments. Monitors and analyzes UM protocols and identifies trends and makes recommendations and develops programs and interventions to...

Job DescriptionPosition Summary:The Denial Nurse is responsible for being the "second line" resource for preparing and maintaining health plan criteria for the campus Medical Directors. This includes collaborating with each Health Plan to obtain updated/adequate criteria for each specialty to ensure that appropriate criteria are referenced upon furnishing a...

The Assistant Store Manager assist the Store Director to oversee all aspects of store operations including store revenue and goals. They must use clear and consistent communication with customers, employees, and vendors. They are ultimately responsib Store Manager, Assistant Store Manager, Manager, Store Director, Store Employee, Assistant, Retail, Grocery

Job DescriptionPosition Summary:The Inpatient Coordinator is responsible for supporting the process that manages all hospital and skilled nursing admissions, concurrent review, and discharge planning. The goal of the Inpatient Care Coordinator is to effectively support the in-patient management process by assuring the right information is provided timely to...

Job DescriptionPosition Summary: The Inpatient Coordinator is responsible for supporting the process that manages all hospital and skilled nursing admissions, concurrent review, and discharge planning. The goal of the Inpatient Care Coordinator is to effectively support the in-patient management process by assuring the right information is provided timely to...

Job DescriptionPosition Summary:This is a temporary position. Assist the Chief Medical Officer ("CMO") in all aspects of her job responsibilities locally, as well as on a corporate level, on a daily basis.Essential Duties and Responsibilities include the following:Manage all incoming calls to CMO. If possible dealing with each issue personally, reducing...

Job DescriptionAfter Hours work schedule: Fully remote, 3 weeknights from 5 pm - 9 pm; 12 hour shift every weekend from 8 am - 9 pm, and 12 hour shift every holiday from 8 am - 9 pm.We are looking for Inpatient Coordinators to join our team in Northridge after hours team to help support our members in the San Fernando /Simi Valley areas.Position Summary:The...

**Position Summary**: This position will provide day-to-day support as a Medical Group Accounts Receivable Specialist. This position focuses almost entirely on accounts receivable follow-up and is responsible for performing third party insurance follow-up in the Central Billing Office. The personnel within this position are responsible for accomplishing...

**Requisition ID: R10158905**: - ** Category**: Global Supply Chain - **Location**: Northridge, California, United States of America - **Clearance Type**: None - **Telecommute**: No - Teleworking not available for this position - **Shift**: Days (United States of America) - **Travel Required**: Yes, 10% of the Time - **Relocation Assistance**: Relocation...

To get this new adventure started, pick up the phone and call us today.Must have active state licenseBC requiredDays4 - 5 code strokes per day with other neurology patientsCode strokes in ED, in house neuro, ICU stroke and neuro coverageCredentialing neededDEA neededCompetitive compensationPre-paid travel and housingPaid AAA-rated claims made...

Position Title: Clinical SupervisorDepartment: Program Development DepartmentReports To: Senior SupervisorPOSITION SUMMARYWe are seeking a dedicated and experienced Clinical Supervisor to join our team. As the Clinical Supervisor, you will lead our Substance Use Treatment and Field-Based Services program, ensuring the highest quality of care for individuals...

Position Title: Clinical SupervisorDepartment: Program Development DepartmentReports To: Senior SupervisorPOSITION SUMMARYWe are seeking a dedicated and experienced Clinical Supervisor to join our team. As the Clinical Supervisor, you will lead our Substance Use Treatment and Field-Based Services program, ensuring the highest quality of care for individuals...

Job DescriptionPosition Summary:Responsibilities include but are not limited to data entry, maintenance, and reporting in, of and from the Contract Database (CDB); verification and processing of various forms used by, Network Management, HR, Corporate and IS; and gathering provider information from a variety of sources.Essential Duties and Responsibilities...

**Essential Duties and Responsibilities include the following**: - Schedule interviews for hiring managers in multiple locations. - Assist in managing 40-150 openings at any given time. - Manage full cycle recruitment for assigned requisitions. - Pre-screen, forward and follow-up on resume submittals to Hiring Managers. - Track and facilitate testing and...

Job DescriptionPosition Summary: Credential all new providers, Re-credential existing Providers according to Regal Medical Group credentialing policies and procedures. Submit credentialing information as requested by contracted HMOs. Maintain and update files on all credentialed Providers. Provide credentialing information on a Provider when requested by...

Job DescriptionPosition Summary:Responsible for entering encounter data onto the claims adjudication system. In addition, and/or data enter encounter information onto the HMO system(s).Essential Duties and Responsibilities include the following:Responsible for the accurate and timely completion of tasks assigned and adhering to hourly/daily production...

Job DescriptionPosition Summary: Provides support in the ongoing maintenance and configuration of Regal Medical Group systems, including but not limited to the data entry of Contracting Database, Providers, Vendors, Fee schedules, Capitation Configuration. Performs system maintenance functions in a manner that is responsive to customer needs and support...