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37 jobs found
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    • Other (27)
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  • Company:
    CalOptima (off)
  • City:
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 Job Title / Description ( show titles only ) CompanyLocation
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Personal Care Coordinator (LTSS) (14182-033115) - View similar jobs
Job type: Full-Time
This position will be responsible for requesting member’s clinical records from long term care facilities, sharing receipt of clinical information...
CalOptima
CA - Orange
Today
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Executive Director, Compliance (13121-033115) - View similar jobs
Job type: Full-Time
The Executive Director of Compliance shall serve as the Compliance Officer for the organization. The Executive Director coordinates and communicates...
CalOptima
CA - Orange
Today
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Health Network Liaison Specialist (14306-033115) - View similar jobs
Job type: Full-Time
The Health Network Liaison Specialist is a liaison between the networks or groups and CalOptima regarding coordination of care and / or service issues...
CalOptima
CA - Orange
Today
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HR REPRESENTATIVE (ANALYST) (13032-033015) - View similar jobs
Job type: Full-Time
Under general supervision, provides technical support related to human resources information and business processes for the Human Resources Department...
CalOptima
CA - Orange
Yesterday
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ONECARE CONNECT CUSTOMER SERVICE REPRESENTATIVE (14224-14225-14226-14227-14228-14229-14230-032715) - View similar jobs
Job type: Full-Time
This position will provide telephonic customer service to potential and newly enrolled OneCare Connect members, facilitating the direction of each...
CalOptima
CA - Orange
2 Days Ago
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Social Worker (In Home Supportive Services Liaison) (15122-032615) - View similar jobs
Job type: Full-Time
This position provides care coordination between CalOptima, health networks, the Orange County Social Services Agency (SSA) In Home Supportive...
CalOptima
CA - Orange
5 Days Ago
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Supervisor, Health Education (96246-032615) - View similar jobs
Job type: Full-Time
The Supervisor of Health Education will be responsible for daily operation of health education activities and supervision of health education staff...
CalOptima
CA - Orange
5 Days Ago
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Supervisor, OneCare Connect Customer Service (14237-032615) - View similar jobs
Job type: Full-Time
The OneCare Connect Customer Service Supervisor (OCCCSS) is responsible for providing support in the daily operation of the OneCare Connect call...
CalOptima
CA - Orange
5 Days Ago
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Medical Authorization Assistant (Concurrent Review) (14174-032515) - View similar jobs
Job type: Full-Time
The Medical Authorization Assistant (MA) provides office and referral management support services and assists the inpatient Case Managers in obtaining...
CalOptima
CA - Orange
6 Days Ago
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Medical Case Manager (Concurrent Review) (14180-14179-14245-06685-032515) - View similar jobs
Job type: Full-Time
Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Direct...
CalOptima
CA - Orange
6 Days Ago
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Grievance Resolution Specialist (10069-032515) - View similar jobs
Job type: Full-Time
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to...
CalOptima
CA - Orange
6 Days Ago
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Grievance and Appeals Nurse Specialist (08026-032515) - View similar jobs
Job type: Full-Time
The ideal candidate will manage the department work activities to ensure that service standards are met, and operations are consistent with the health...
CalOptima
CA - Orange
6 Days Ago
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Clinical Auditor (LVN) (14336-032515) - View similar jobs
Job type: Full-Time
The Clinical Auditor (LVN) will conduct routine oversight, monitoring and auditing, of all internal business functions within CalOptima, as well as...
CalOptima
CA - Orange
6 Days Ago
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HEALTH EDUCATOR (15070-031715) - View similar jobs
Job type: Full-Time
Responsible for planning, implementing and evaluating health education activities for CalOptima members. Provides individual and group health...
CalOptima
CA - Orange
2 Weeks Ago
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FINANCIAL ANALYST, SR. (ACTUARIAL SERVICES) (14143-031715) - View similar jobs
Job type: Full-Time
This position is responsible for the development of systematic processes to analyze, process, and reconcile revenue and enrollment data. It entails...
CalOptima
CA - Orange
2 Weeks Ago
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Data Entry Tech (14031-031715) - View similar jobs
Job type: Full-Time
Provide data entry services to various areas of the organization. Perform routine to complex data entry and data maintenance functions. Responsible...
CalOptima
CA - Orange
2 Weeks Ago
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PROGRAM SPECIALIST (TRANSLATION & INTERPRETER SERVICES) (15035-121714) - View similar jobs
Job type: Full-Time
Under general supervision, this position supports CalOptima’s compliance with cultural and linguistic (C&L) State and Federal regulatory requirements...
CalOptima
CA - Orange
2 Weeks Ago
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MEDICAL AUTHORIZATION ASSISTANT (14084-031715) - View similar jobs
Job type: Full-Time
Provides office and case management support services. Serves as a contact between members, physicians, providers and CalOptima staff to gather...
CalOptima
CA - Orange
2 Weeks Ago
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MEDICAL AUTHORIZATION ASSISTANT (LTC) (14181-031615) - View similar jobs
Job type: Full-Time
Provides office and case management support services. Serves as a contact between members, physicians, nursing home facilities, community based...
CalOptima
CA - Orange
2 Weeks Ago
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AUDITOR, SR. (GARS) (14331-031315) - View similar jobs
Job type: Full-Time
The Grievance and Appeals Auditor, Sr. is responsible for auditing grievance and appeal activity performed within the GARS department to ensure that...
CalOptima
CA - Orange
2 Weeks Ago
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CLINICAL AUDITOR, SR. (RN-LVN) (14334-031315) - View similar jobs
Job type: Full-Time
This position serves as the auditor for Quality Improvement (QI), Utilization Management (UM), and Clinical Grievances (GARS) oversight. This position...
CalOptima
CA - Orange
2 Weeks Ago
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CLINICAL AUDITOR (LVN) (12041-031315) - View similar jobs
Job type: Full-Time
The Clinical Auditor (LVN) will conduct routine oversight, monitoring and auditing, of all internal business functions within CalOptima, as well as...
CalOptima
CA - Orange
2 Weeks Ago
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ONECARE/COMMUNITY PARTNER-SALES (15147-031015) - View similar jobs
Job type: Full-Time
This position will perform education, marketing and sales tasks associated with obtaining new members in the OneCare program by making community...
CalOptima
CA - Orange
3 Weeks Ago
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COMPLIANCE ANALYST, SR. (PRIVACY AND FWA) (13053-012915) - View similar jobs
Job type: Full-Time
Under the direction of the Manager, Privacy, the Sr. Compliance Analyst primarily assists with the development, implementation, maintenance of, and...
CalOptima
CA - Orange
3 Weeks Ago
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BUSINESS ANALYST (GARS) (15137-030615) - View similar jobs
Job type: Full-Time
Supports all data management reporting, provides support to the Director and Managers on specialized tasks relevant to an assigned program and/or...
CalOptima
CA - Orange
3 Weeks Ago