Healthcare Operations Coordinator
1 day ago
About E-talentnetwork
">We are seeking a skilled Healthcare Operations Coordinator to join our team on a 2-month contract with the possibility of extension.
About the Role:
This role involves ensuring that New Century Health Plan members receive high-quality, cost-effective care. You will conduct utilization management activities in line with health plan policies and regulatory guidelines.
You will identify Potential Quality Issues (PQI) and support Provider Dispute Resolution (PDR) processes to ensure compliance and enhance provider satisfaction.
Responsibilities:
- Conduct thorough clinical assessments to evaluate medical necessity and appropriateness of care
- Develop and execute effective UM strategies to optimize member outcomes and reduce costs
- Work with healthcare providers to resolve potential quality issues and improve patient care
- Analyze data to identify trends and opportunities for process improvement
- Communicate complex information to various stakeholders, including providers, members, and internal teams
Qualifications:
- A BSN or MSN degree
- A current valid California RN license
- At least two years of experience in utilization management, preferably in Medicare Advantage or managed care
- Knowledge of Medicare Advantage regulatory guidelines, including CMS regulations
- Experience with PQI identification and reporting
- Familiarity with PDR processes
- Strong clinical assessment and critical thinking skills
- Proficiency in electronic health records (EHR) and utilization management software
- Excellent written and verbal communication skills
What We Offer:
E-talentnetwork values diversity and inclusion and encourages applications from a wide range of candidates. All qualified applicants will receive consideration for employment without bias.
The estimated salary range for this position is $80,000 - $110,000 per year, based on experience.
],-
Healthcare Operations Coordinator
2 weeks ago
Los Angeles, California, United States AltaMed Full timeThe Healthcare Operations Coordinator is a key role at AltaMed, responsible for synchronizing operations involved in project completion. This position works under the direction of the Director to maintain project plans, calendars, dashboards, and activities, as well as assist with budgeting and staying up-to-date on relevant legal regulations. A successful...
-
Healthcare Operations Coordinator
2 weeks ago
Los Angeles, California, United States UMMA Community Clinic Full timeJob SummaryWe are seeking a detail-oriented and organized Patient Care Coordinator to join our team at UMMA Community Clinic. As a key member of our operations team, you will be responsible for facilitating the smooth flow of patients, clients, and work throughout the organization.
-
Healthcare Operations Coordinator
2 weeks ago
Los Angeles, California, United States Optum Full timeCompany OverviewAt Optum, we strive to deliver exceptional care to millions of people worldwide. Our team is dedicated to connecting patients with the resources they need to live healthier lives. As a leading health services organization, we prioritize diversity, inclusion, and employee development.Job SummaryWe are seeking an Associate Patient Care...
-
Healthcare Operations Specialist
2 weeks ago
Los Angeles, California, United States TBWA\Chiat\Day Full timeOverview">We are seeking a highly skilled and detail-oriented Healthcare Operations Specialist to join our team. In this role, you will play a critical part in ensuring the smooth operation of our healthcare services.">About Us">TBWA\\(Chiat\\(Day">is a global advertising agency that helps businesses succeed through creative and effective marketing...
-
Healthcare Coordinator
2 weeks ago
Los Angeles, California, United States 365 Healthcare Staffing Services, Inc. Full timeWe are seeking a highly skilled and detail-oriented Vocational Nurse to join our team as a Healthcare Coordinator at 365 Healthcare Staffing Services, Inc. in an exciting opportunity for a professional looking to advance their career.About the Job:This role involves coordinating patient flow and ensuring efficient use of time. The successful candidate will...
-
Administrative Coordinator
1 day ago
Los Angeles, California, United States Healthcare Staffing Professionals, Inc Full timeAbout the RoleThis Financial Administrative Assistant position at Healthcare Staffing Professionals, Inc. offers an exciting opportunity to make a meaningful impact in the organization's financial operations. The successful candidate will work closely with the Operations Support Bureau to analyze and optimize budget, systems, and procedures, ensuring maximum...
-
Healthcare Operations Manager
2 weeks ago
Los Angeles, California, United States Insight Global Healthcare Full timeAbout Insight Global HealthcareInsight Global Healthcare is a leading healthcare organization dedicated to delivering exceptional patient care and services.Salary Range:$85,000 - $115,000 per year, depending on experience.Job SummaryWe are seeking a highly skilled and experienced Patient Access Manager to oversee daily operations and ensure alignment with...
-
Healthcare Operations Manager
2 weeks ago
Los Angeles, California, United States University of California Full timeJob DescriptionWe are seeking a highly skilled and experienced Utilization Management Supervisor to join our team at UCLA Health.About the RoleThis leadership position is responsible for managing the day-to-day operations of the UM department, including coordinating staff schedules, developing workflows, and resolving patient/provider issues related to...
-
Healthcare Operations Specialist
4 weeks ago
Los Angeles, California, United States LifeStance Health Full timeWe are seeking a skilled and compassionate Healthcare Operations Specialist to join our team at LifeStance Health. This role is ideal for individuals who thrive in fast-paced environments and are passionate about delivering exceptional patient care.As a Healthcare Operations Specialist, you will play a vital role in ensuring the smooth operation of our...
-
Administrative Operations Coordinator
2 weeks ago
Los Angeles, California, United States Heluna Health Full timeWe are seeking a highly organized and detail-oriented Administrative Operations Coordinator to join our team at Heluna Health. This is a full-time benefitted position that offers a competitive salary range of $31.25 - $43.27 per hour.Job Description:The Administrative Operations Coordinator will play a vital role in supporting the Operations team by...
-
Healthcare Network Logistics Coordinator
2 days ago
Los Angeles, California, United States PIH Health Full timeAbout PIH HealthAt PIH Health, we strive to deliver exceptional patient care and experience. Our regional healthcare network serves approximately 3 million residents in Los Angeles County, Orange County, and the San Gabriel Valley region.About the JobWe are hiring a skilled Healthcare Network Logistics Coordinator to join our team. As a Logistics...
-
Healthcare Service Coordinator
1 day ago
Los Angeles, California, United States Mens Health Foundation Full timeJob Title: Healthcare Service CoordinatorAbout UsMens Health Foundation is a leading organization dedicated to delivering exceptional healthcare services in a compassionate and patient-centered environment. Our mission is to provide high-quality care with a focus on growth, development, and inclusivity.Salary Range: $45,000 - $65,000 per yearJob...
-
Referrals Operations Coordinator
2 weeks ago
Los Angeles, California, United States To Help Everyone Full timeAbout UsTo Help Everyone (T.H.E.) Health and Wellness Centers is a healthcare organization dedicated to providing quality care to our patients.Job SummaryWe are seeking a skilled Referrals Operations Coordinator to join our team. As a Referrals Operations Coordinator, you will be responsible for overseeing the daily operations of referrals submission and...
-
Healthcare Coordinator Specialist
2 weeks ago
Los Angeles, California, United States OneStaff Medical Full timeWe are OneStaff Medical, a nationally recognized and independently owned staffing firm dedicated to delivering exceptional care and support to our clients. At the heart of our mission is a commitment to helping healthcare professionals find their dream assignments and excel in their careers.The Role: Case Management NurseAs a seasoned Case Management Nurse,...
-
Healthcare Referral Coordinator
2 weeks ago
Los Angeles, California, United States South Central Family Health Cent Full timeJob OverviewWe are seeking a skilled Healthcare Referral Coordinator to join our team at South Central Family Health Center. This role plays a vital part in ensuring the seamless coordination of patient referrals, authorizations, and notifications.As a Healthcare Referral Coordinator, you will be responsible for:Coordinating interdepartmental patient...
-
Medical Operations Coordinator
2 weeks ago
Los Angeles, California, United States CEDARS-SINAI Full timeAbout the JobCedars-Sinai is a leader in providing high-quality healthcare services. We are seeking a highly skilled Medical Operations Coordinator to support our physician practice in Orthopedics.The successful candidate will play a key role in ensuring a smooth and efficient front and back office workflow, coordinating patient care with medical assistants,...
-
Physical Therapy Operations Coordinator
2 days ago
Los Angeles, California, United States University of Southern California Full timeThe Physical Therapy Operations Coordinator will be responsible for coordinating daily operations at the USC Physical Therapy practice, ensuring efficient and effective delivery of patient care. Key responsibilities include scheduling patient appointments, managing patient records, and communicating with healthcare professionals.This role offers a...
-
Healthcare Operations Manager
2 weeks ago
Los Angeles, California, United States AltaMed Full timeCompany Overview:At AltaMed, we are committed to providing exceptional care to our communities. Our organization is dedicated to delivering high-quality healthcare services that meet the unique needs of each patient. We believe in fostering a culture of compassion, respect, and collaboration among our staff, ensuring that every individual receives...
-
Healthcare Coordinator Specialist
5 days ago
Los Angeles, California, United States CEDARS-SINAI Full timeCedars-Sinai is a renowned leader in medical care excellence, consistently recognized with prestigious awards for its commitment to quality patient care.We offer an attractive compensation package and competitive salaries that reflect the value we place on our staff's expertise and dedication.About the RoleThe Healthcare Coordinator Specialist provides...
-
Administrative Operations Coordinator
2 weeks ago
Los Angeles, California, United States Agape Adult Home Care Llc Full timeJob OverviewAgape Adult Home Care LLC is a leading provider of adult home care services.Estimated Salary Range$45,000 - $60,000 per year, depending on experience and qualifications.Job DescriptionWe are seeking an experienced Administrative Manager to oversee office operations and support the growth of our business. As an Administrative Manager, you will be...