CALOPTIMA jobs in TUSTIN CA, United Kingdom

Business Analyst, Sr. (Contracting) CalOptima CalOptima Health is seeking a highly motivated an experienced...: Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff...

Medical Authorization Assistant (Multipurpose Senior Services Program) CalOptima CalOptima Health is seeking... services. The incumbent will serve as a contact between members, physicians, providers and CalOptima Health's staff to gather...

Member Liaison Specialist (Customer Service) (Bilingual) CalOptima CalOptima Health is seeking a highly motivated... and social service needs both within and outside the health network and CalOptima Health during the original interaction...

Financial Analyst II (Budgeting) CalOptima CalOptima Health is seeking a highly motivated an experienced Financial... department in developing, monitoring, and analyzing CalOptima Health's administrative, medical management, and capital budgets...

Claims Resolution Specialist (Claims) CalOptima CalOptima Health is seeking a highly motivated an experienced... conjunction with CalOptima Health's policies and procedures that apply to claims adjudication and adjustment of claims. The...

Program Assistant (Case Management) CalOptima CalOptima Health is seeking a highly motivated an experienced Program... with other departments, external stakeholders and CalOptima Health's general office system. The incumbent will coordinate work or processes...

Manager, Accounting CalOptima CalOptima Health is seeking a highly motivated an experienced Manager, Accounting... Applies a thorough understanding of CalOptima Health's policies and procedures, general ledger structures, and financial...

Customer Service Representative, Sr. (OneCare-Bilingual Required) CalOptima CalOptima Health is seeking a highly... medical group and CalOptima Health. Enters accurate and complete documentation into internal application systems regarding...

Supervisor, Behavioral Health (Utilization Management) CalOptima Health is seeking a highly motivated an experienced... will be accountable for establishing and achieving quality and productivity standards and ensuring compliance with CalOptima Health...

. The incumbent will utilize CalOptima Health's medical criteria, policies and procedures to authorize referral requests... and/or CalOptima Health's Customer Service department regarding health network enrollments. Identifies and reports any complaints...

incumbent will provide information regarding eligibility, enrollment, benefits and services to CalOptima Health's eligible...

Coordinator will support CalOptima Health's Whole Child Model (WCM) procedures. The incumbent will support with processing routine... along with processing Annual Medical Review (AMR) and Inter-County Transfers (ICT) for WCM members. The incumbent will work with CalOptima...

documentation of the member's case, care plan and interdisciplinary care team within CalOptima Health's medical management system.... Bilingual in English and one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish...

. Bilingual in English and one of CalOptima Health’s defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish...

Client: CalOptima Health Job Title: Care Manager Duration: 06+ Months Start Date: ASAP Location: 505 City..._HD104_IK Job ID: 104 Description: CalOptima Health is seeking a highly motivated an experienced TEMP - Care Manager (2...

, as appropriate, including Community Supports and LTSS. Conducts face-to-face meetings at settings outside of CalOptima Health... goals/priorities for the department. Follows CalOptima Health's protocol for documenting all case interventions. Ensures...

for accuracy and existence of coverage specific to the line of business. Contacts the health networks and/or CalOptima Health... required. Knowledge & Abilities: Develop rapport and establish and maintain effective working relationships with CalOptima Health...