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Social Worker (PACE) (Bilingual Required) 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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Medical Assistant (PACE) 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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Supervisor Nursing Services (PACE) 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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Supervisor Grievance and Appeals 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 Rep Sr (Behavioral Health) in 505 City Parkway West
The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and providers with questions related to the Medi-Cal programs.
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Manager PACE Center 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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Customer Service Representative Sr (OneCare) (Bilingual Required) in 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.
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Program/Policy Analyst Sr, Covered California - Regulatory Affairs in 505 City Parkway West
RAC ensures CalOptima Health maintains compliance with all regulatory and contractual obligations across its Medi-Cal and Covered California lines of business. RAC serves as the liaison to key regulators—including the California Department of Health Care Services (DHCS), Covered California, the Department of Managed Health Care (DMHC), and the Centers for Medicare & Medicaid Services (CMS)—by disseminating timely regulatory updates, interpreting statutory and sub regulatory requirements, managing audits, overseeing corrective actions, and ensuring accurate, timely regulatory reporting and filings.
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Manager Regulatory Affairs and Compliance, Covered California in 505 City Parkway West
RAC ensures CalOptima Health maintains compliance with all regulatory and contractual obligations across its Medi-Cal and Covered California lines of business. RAC serves as the liaison to key regulators—including the California Department of Health Care Services (DHCS), Covered California, the Department of Managed Health Care (DMHC), and the Centers for Medicare & Medicaid Services (CMS)—by disseminating timely regulatory updates, interpreting statutory and sub regulatory requirements, managing audits, overseeing corrective actions, and ensuring accurate, timely regulatory reporting and filings.
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ITS Analyst Sr, Finance Systems in 505 City Parkway West
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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Data Analyst Sr, Finance - Encounter Data (Covered California) in 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.
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Chief Executive Officer in 505 City Parkway West
The Chief Executive Officer will help shape the future of healthcare and be an integral part of the team, we are Better Together.
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Sr Fraud, Waste and Abuse Investigator (Investigator Sr) in 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.
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