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Manager Grievance & Appeals (Provider Services) in 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.
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Customer Service Representative in 505 City Parkway West
The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and provider with questions related to the Med-Cal programs.
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Claims Examiner in 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.
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Interdisciplinary Team Lead (Program Specialist) in 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.
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Sr Manager, Fraud, Waste and Abuse (Investigations) (Sr Manager I) in 505 City Parkway West
The Sr Manager I for Fraud, Waste and Abuse (FWA) will be responsible for leading the team of CalOptima Health investigators to detect, investigate and mitigate FWA issues.
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