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Director, Quality Initiatives (Director III) in 505 City Parkway West
CalOptima Health is seeking a seasoned leader to oversee quality improvement initiatives to improve Medi-Cal and Medicare quality ratings.
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Grievance Resolution Specialist (Provider Resolution) 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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Program Manager Sr (Quality Analytics (CMS Stars)) in 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.
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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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Enterprise Analytics Manager (Principal Business Intelligence Analyst – Tableau) in 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.
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