|
Grievance Resolution Specialist
|
505 City Parkway West
|
|
| 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. |
|
Quality Improvement Specialist (Equity & Practice Transformation Program)
|
505 City Parkway West
|
|
| CalOptima Health is seeking a quality specialist to develop training materials and educate providers on quality principles and methods to improve health outcomes and member satisfaction. |
|
Sr Manager, Marketplace Program Development (Sr Manager II)
|
505 City Parkway West
|
|
| Strategic Development is responsible for oversight and facilitation of effective strategy planning and execution by developing, implementing, managing, and coordinating strategic priorities and key processes through organizational alignment, cross-collaboration, and operational improvement to achieve CalOptima Health goals and objectives. |
|
LVN (PACE)
|
PACE - Garden Grove
|
|
| PACE is a health services plan designed for people of age 55 and older, who have ongoing health care needs. The services provided are all inclusive and authorized by the interdisciplinary team. |
|
Customer Service Coordinator (OneCare Call Center) (Bilingual Required)
|
505 City Parkway West
|
|
| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and providers with questions related to the OneCare Plan services. |
|
Actuarial Analyst
|
505 City Parkway West
|
|
| 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, participate in annual budgeting functions. |
|
Director, Quality Initiatives (Director III)
|
505 City Parkway West
|
|
| CalOptima Health is seeking a seasoned leader to oversee quality improvement initiatives to improve Medi-Cal and Medicare quality ratings. |
|
Grievance Resolution Specialist (Provider Resolution)
|
505 City Parkway West
|
|
| 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. |
|
Program Manager Sr (Quality Analytics (CMS Stars))
|
505 City Parkway West
|
|
| CalOptima Health is seeking an experienced Program Manager Sr to develop and implement enterprise-wide initiatives to improve Star and quality outcomes for Medicare members. |
|
Customer Service Representative Sr (OneCare) (Bilingual Required)
|
505 City Parkway West
|
|
| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and providers with questions related to the OneCare Plan services. |
|
Program Manager Sr (Marketplace)
|
505 City Parkway West
|
|
| Strategic Development is responsible for oversight and facilitation of effective strategy planning and execution by developing, implementing, managing, and coordinating strategic priorities and key processes through organizational alignment, cross-collaboration, and operational improvement to achieve CalOptima Health goals and objectives. |
|
Program Specialist (Credentialing)
|
505 City Parkway West
|
|
| CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities. |
|
Program Coordinator (Credentialing)
|
505 City Parkway West
|
|
| CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities. |
|
Medical Assistant (PACE)
|
PACE - Garden Grove
|
|
| PACE is a health services plan designed for people of age 55 and older, who have ongoing health care needs. The services provided are all inclusive and authorized by the interdisciplinary team. |
|
Program Assistant (Quality Improvement)
|
505 City Parkway West
|
|
| CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities. |