Expression of interest

Loading...

Current opportunities

Position Location Closes
Claims Resolution Specialist 505 City Parkway West
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.
Program Manager Sr, Vendor Management - Covered California 505 City Parkway West
Procurement & Vendor Management is responsible for obtaining goods and services needed by CalOptima, ensuring compliance with all statutes and regulations regarding public procurement.
Medical Authorization Assistant (Behavioral Health - Utilization Management) - Covered California 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal, OneCare and Covered California Members.
Engagement & Partnerships Representative (Community Relations Specialist) 505 City Parkway West
The Community Relations Specialist (Engagement & Partnerships Representative) is responsible for executing local and provider-focused engagement strategies to strengthen member relationships, raise awareness of CalOptima Health’s Medicare Advantage/OneCare offerings, and support retention goals.
Sr Fraud, Waste and Abuse Investigator (Investigator Sr) 505 City Parkway West
Under general direction, the Investigator Sr for Fraud, Waste & Abuse (FWA) will support the detection, prevention, investigation, mitigation and reporting of FWA issues.
Program Manager, Community Health 505 City Parkway West
The Program Manager for Equity and Community Health (ECH) will play a vital role in the program design, development, implementation and support of ECH initiatives, pilots and programs.
Regulatory Affairs & Compliance Analyst, Policies & Procedures 505 City Parkway West
Under the direction of the Manager, Regulatory Affairs & Compliance, the Regulatory Affairs & Compliance Analyst (Policies and Procedures) supports the development, communication, and implementation of CalOptima Health policies and procedures.
Financial Analyst III (Insurance Risk) 505 City Parkway West
The Finance department is responsible for procuring business insurance, reviewing the financial viability of the delegated entities, and processing delegated entities’ inbound encounter data to submit along with in-house claims data to CMS and DHCS as outbound encounter data for all lines of business.
Director, Human Resources - Total Rewards (Director III) 505 City Parkway West
The Human Resources department believes happy employees are key to our success. We're seeking a passionate HR professional to champion talent acquisition, drive positive culture, and help us grow and thrive. Come be a part of our story and make a real impact!
Supervisor Behavioral Health 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal, OneCare and Covered California Members.
Intern (Community Relations) - Fall 2026 505 City Parkway West
The Community Relations Department strives to strengthen partnerships by enhancing communications, understanding, and mutual support between CalOptima Health and community organizations.
Business Analyst Sr, Provider Data Operations - Covered California 505 City Parkway West
The Provider Data Operations department is responsible for managing operations of the provider network to ensure timely access to care for our members.
Member Liaison Specialist Sr, Behavioral Health Clinical / Care Management - Covered California 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal, OneCare and Covered California Members.
Member Liaison Specialist Sr - Covered California (BHI-BHT/ABA) 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal, OneCare, and Covered California Members.
Clinician Sr, Behavioral Health - Clinical/Care Management - Covered California (Clinician Sr) 505 City Parkway West
The Behavioral Health Integration Department directly manages Behavioral Health Services for CalOptima Health Medi-Cal, OneCare and Covered California Members.
Business Analyst Sr, Claims - Covered California 505 City Parkway West
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.
Manager Quality Improvement (PQI) 505 City Parkway West
CalOptima Health's Quality Improvement (QI) department is responsible for the execution and coordination of quality assurance and improvement activities.
Data Analyst Sr, Finance - Encounter Data - Covered California 505 City Parkway West
The Finance department is responsible for procuring business insurance, reviewing the financial viability of the delegated entities, and processing delegated entities’ inbound encounter data to submit along with in-house claims data to CMS and DHCS as outbound encounter data for all lines of business.
Grievance & Appeals Nurse 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.
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.

More Jobs 25