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Sr. Program Manager, Public Policy (Program Manager Sr) in 505 City Parkway West
The Program Manager Sr for Public Policy will play a vital role in the design, development, implementation and overall support of public policy priorities and initiatives to further the goals of CalOptima Health.
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Sr Manager, Individual and Family Plans (Sr Manager II) in 505 City Parkway West
The Sr Manager for Individual and Family Plans will be responsible for supporting the development of new programs and initiatives related to the implementation and ongoing management of new product lines, including commercial.
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ITS Architect IV (Release Train Engineer/SDLC Architect) in 505 City Parkway West
The ITS Architect IV (Release Train Engineer/Agile Software Development Life Cycle (SDLC)) will define the enterprise Agile Release Trains (ARTs) and SDLC methodology for CalOptima Health to enhance team collaboration, cross-functionality and delivery efficiency.
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Lead Decision Support Analyst (Principal Financial Analyst) in 505 City Parkway West
The Principal Financial Analyst (Decision Support) will be responsible for providing highly complex analysis, guidance and expert knowledge on health care finance for various departments within CalOptima Health.
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Claims Examiner Sr in 505 City Parkway West
The Claims Examiner Sr. analyzes and processes claims. This position is responsible for following regulatory and internal guidance in conjunction with CalOptima policies and procedures as they apply to claims adjudication. The Claims Examiner is responsible to adjudicate claims that require minimal research and problem solving. 3-4 years of health claims processing background. Knowledge of Medicare and Medi-Cal processing preferred. Examiner is expected to adjudicate tier one claim type with attention to detail in order that high quality standards are met. The challenge of consistently and accurately processing an increased volume of claims in a production environment is attainable with appropriate staffing levels. The return on the investments is that the approval of this position will allow us to continue meeting regulatory compliance and timeliness requirements.
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