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Manager Quality Improvement, PQI
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505 City Parkway West
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| CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities. |
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Grievance Resolution Specialist
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505 City Parkway West
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| The Grievance and Appeals Resolution Services (GARS) Department is responsible for coordinating thorough reviews to provide appropriate resolutions to verbal and written complaints, appeals and disputes for both members and providers. |
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Financial Analyst I, Budgeting
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505 City Parkway West
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| The Budget Department is responsible for planning, developing and managing the financial resources of the organization. The main responsibilities include developing and managing annual operating budgets and providing insights and recommendations to support strategic decision-making. |
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Actuarial Analyst
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505 City Parkway West
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| The Financial Analysis Department is responsible for the development of various financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, and participate in annual budgeting functions. |
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ITS Analyst Sr, Configuration, Covered California
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505 City Parkway West
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| The Claims Administration Department is responsible for managing and processing of all medical claims in accordance with industry standards and regulations, ensuring accuracy and timely reimbursement to healthcare providers. |