Browse Jobs
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Partnership HealthPlan of California
To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals an
Partnership HealthPlan of California
The AV Support Technician will help implement and maintain regional video collaboration tools to support Partnership HealthPlan’s communication needs. This role involves assisting with setup, basic troubleshooting, and providing support to staff and team members using AV equip
Partnership HealthPlan of California
To provide coordination and implementation support of defined tasks for the assigned program(s).
Partnership HealthPlan of California
The Manager of Medicare Marketing and Sales will oversee the development and execution of Partnership’s Medicare D-SNP marketing and sales strategy focused on driving smart and measurable growth. The Marketing manager will lead a team that collaborates with Partnership leadership
Partnership HealthPlan of California
To provide support to day-to-day IT production operations support, and systems and telecommunications support. In addition to the IT Helpdesk Operator I duties, the IT HelpDesk Operator II has a higher level of experience in HelpDesk management and resource coordination. The IT H
Partnership HealthPlan of California
Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.
Partnership HealthPlan of California
The incumbent utilizes clinical judgement in providing utilization management services. The focus is to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. Assists in determin
Partnership HealthPlan of California
To design, develop, and test data transformations processes and related process automation at Partnership. To work with the Manager of Web Application Development in the design, development, testing, maintaining and migrating the databases and its related processes. Works closel
Partnership HealthPlan of California
Under the direction of the Associate Director of Internal Audit or above, the Manager of Overpayment Recovery Services is responsible for overseeing the Provider Check Posting and Recovery Teams, while coordinating with administrative support to drive departmental initiatives.
Partnership HealthPlan of California
This position designs, develops, presents, and/or facilitates innovative and engaging organization-wide Instructor-Led Trainings (ILT), video trainings, and other trainings as requested. Works with department Subject Matter Experts (SMEs) on designing and/or standardizing targete
Partnership HealthPlan of California
The Manager of Web Applications Development is responsible for managing concurrent web and desktop development initiatives, including project level resource assignments, time estimates, and project planning details. The manager works with the Director of Web Application Developme
Partnership HealthPlan of California
To plan, organize, manage, and implement projects.
Partnership HealthPlan of California
The Housing Services Coordinator is responsible for reviewing, approving, and supporting requests for housing-related services for Community Supports services offered by the health plan. This role ensures that housing related services are appropriate, align with program criteria
Partnership HealthPlan of California
To respond to member and provider inquiries regarding case management telephonically. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and/or entered as a referral for case management while providing the highest
Partnership HealthPlan of California
The Coordinator I will provide coordination and administrative support to department teams and management. Performs a variety of general clerical duties, including data entry, report generation, manage and respond to call inquiries, manage internal Helpdesk inquiries, manage and
Partnership HealthPlan of California
Supervise daily operations and provide leadership, support, and direction to assigned Provider Relations Representative staff. Ensure the highest level of customer service is a priority of PR staff. Monitor department goals and meet deadlines. Recruit and retain Provider network.
Partnership HealthPlan of California
To provide administrative support to the executive leader, leadership teams, and staff as assigned. In addition to the Administrative Assistant II duties, the Executive Assistant has a higher level of education and experience and more autonomy, works with a higher level of intern
Partnership HealthPlan of California
The AV Support Technician will help implement and maintain regional video collaboration tools to support Partnership HealthPlan’s communication needs. This role involves assisting with setup, basic troubleshooting, and providing support to staff and team members using AV equip
Partnership HealthPlan of California
In collaboration with Care Coordination team members, this position provides support and guidance to HealthPlan members referred to the Care Coordination Department for Case Management services and programs. The Health Care Guide I works closely with members, families, providers,
Partnership HealthPlan of California
To begin Treatment Authorization Requests (TAR) reviews and perform data entry upon TAR determination by pharmacy staff. Performs eligibility and benefit investigations. Supports pharmacy department with extracting and collecting data for reporting needs. Supports department's ad
Partnership HealthPlan of California
The Manager of Vendor Oversight: D-SNP supports sourcing, contract execution, and performance management for vendor partners that directly support Partnership Advantage Dual Eligible Special Needs Plan (D-SNP). This position is responsible for relationship management with assi
Partnership HealthPlan of California
To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals an
Partnership HealthPlan of California
To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Completes and processes claims and claims worksheets. Creates appropriate documentation that reflects the actions taken and statu
Partnership HealthPlan of California
To develop, implement, improve, and manage assigned programs. In addition to the Program Manager II duties, the Senior Program Manager is a leadership role, has a higher level of education/experience, more autonomy, exercises independent judgment, and provides coaching and guidan
Partnership HealthPlan of California
To support the Claims Department in maintaining pended claims and claim adjustments within established guidelines. Reviews and processes complex claims, and supports claims examining.