Provider Relations Specialist, IPA Network Operations

Job DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Network Management Supervisor, the In-House IPA Representative serves as the liaison between the IPA clients, IPA client’s contracted providers and health plan(s). They will be responsible for the executing the provider onboarding, update, and...

Job Description Job Description TWO POSITIONS AVAILABLE - COMPUTER PROGRAMMER AND SYSTEM ANALYST POSITION 1 - COMPUTER PROGRAMMER: Computer Programmer role is to define, develop, test, analyze, and maintain new software applications in support of the achievement of business requirements. This includes writing, coding, testing, and analyzing software programs...

Job DescriptionJob DescriptionTWO POSITIONS AVAILABLE - COMPUTER PROGRAMMER AND SYSTEM ANALYST POSITION 1 - COMPUTER PROGRAMMER:Computer Programmer role is to define, develop, test, analyze, and maintain new software applications in support of the achievement of business requirements. This includes writing, coding, testing, and analyzing software programs...

Job DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...

Job DescriptionJob DescriptionGENERAL SUMMARYThe Membership Dept. is responsible for researching, adding, terming and updating member information in the Membership System and researching member eligibility in Health Plan and government agency websites to maintain accurate information in the Membership System.PRINCIPAL DUTIES AND RESPONSIBILITIES: Research...

Job DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...

Job Description Job Description Openings for both a Quality Compliance Nurse and a Compliance Coordinator. QUALITY COMPLIANCE NURSE PURPOSE: The Quality and Compliance Nurse is responsible for working with the Medical Director, the VP of Clinical Policy, the QM Committee in developing, implementing, and refining the Quality Management Program. They are also...

Job DescriptionJob DescriptionOpenings for both a Quality Compliance Nurse and a Compliance Coordinator. QUALITY COMPLIANCE NURSEPURPOSE:The Quality and Compliance Nurse is responsible for working with the Medical Director, the VP of Clinical Policy, the QM Committee in developing, implementing, and refining the Quality Management Program. They are also...

Your Role The Provider Network Management team consists of Provider Relations and Contracting in Northern California. The Provider Contracting Specialist, Principal will report to the Director, Provider Contracting. In this role you will be responsible for managing contract negotiations for select providers in Central and Northern California. The job...

Salary Range: $55, Min.) - $69, Mid.) - $82, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...

Salary Range:  $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.)   Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million...

We value our employees! We offer long term employment opportunities with job stability, including supporting and encouraging career growth advancement. We offer Health, Dental and Vision insurance, Paid Time Off, 9 Paid Holidays, 403(b) with Matching Retirement Plan, Life insurance (paid by the company) and a team spirit workplace culture! Provider...

Job DescriptionJob DescriptionNetwork Operations Engineer TraineeSummary of Responsibilities This position is responsible for Network operations encompassing the management, monitoring, and maintenance of a computer network. It involves tasks such as configuring network devices, troubleshooting connectivity issues, optimizing network performance, and...

Job DescriptionJob DescriptionSummaryUnder the general direction of Provider Network Operations (PNO) Project Manager, the Provider Directory Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary functions are...

Job DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management,...

**Full-Time Salaried Position** **About Specialist Direct** Specialist Direct (SDI) is a rapidly growing healthcare technology company. The company’s telehealth solutions provide real-time access to its national network of top medical specialists to deliver superior patient outcomes. SDI is the leader in providing diagnostic, cloud-based solutions which...

Under the direction of the Operations Director and Executive Director, this position is responsible for the negotiation, optimization and the operational management of the managed care contracts; Medi-Cal, Medicare, Commercial, PPO, FFS and etc.Directs negotiation of managed care contracts including optimal capitation rates, fee-for-service reimbursements,...

Position: Resident Relations Specialist Reports to: Assistant General Manager Location: Los Angeles, CA JOB SUMMARY: Possesses strong communication, telephone, and customer service skills. Meets and greets residents; checks guests and service provide Relations, Resident, Specialist, General Manager, Property Management, Business Services

Job Description Job Description Job located in Alhambra, CA, USA Position Summary Under the direction of the Operations Director and Executive Director, this position is responsible for the negotiation, optimization and the operational management of the managed care contracts; Medi-Cal, Medicare, Commercial, PPO, FFS and etc. Schedule: · Flexible, may...

Job DescriptionJob DescriptionThe Quality Management department is seeking a HEDIS/STARs Specialist to assist with clinic engagement in quality performance and patient experience programs. This is a position that may include field work to train staff and providers as well as performing chart abstracts. Duties and Responsibilities:1. Assume primary...