NewMedical Assistant - SRS Primary Care - Rancho Bernardo - Full-Time - Day Shift SHARP HEALTHCAREMedical Assistant - SRS Primary Care - Rancho Bernardo - Full-Time - Day ShiftOrange, CA$35,000–$42,000 / yearSee Sharp HealthCare Terms & Conditions at https://www.sharp.com/patient-rights-privacy/terms-of-use.cfm and Privacy Policy at https://www.sharp.com/patient-rights-privacy/privacy-practices.cfm and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
NewCare Provider Ivy LivingCare ProviderLa Palma, CA$17–$18 / hourli>For the health and safety of our team members and residents, Oakmont Management Group may require team members to vaccinate, participate in daily screening, surveillance testing, and to wear face coverings and other personal protective equipment (PPE) to prevent the spread of the COVID-19 or other communicable diseases, per regulatory guidelines. The Care Provider is responsible for providing personal assistance and daily care and services related to the residents in order to enhance the residents’ independence and quality of life, in accordance with the company’s mission and values.
Care Provider Oakmont Senior LivingCare ProviderHuntington Beach, CAli>For the health and safety of our team members and residents, Oakmont Management Group may require team members to vaccinate, participate in daily screening, surveillance testing, and to wear face coverings and other personal protective equipment (PPE) to prevent the spread of the COVID-19 or other communicable diseases, per regulatory guidelines. The Care Provider is responsible for providing personal assistance and daily care and services related to the residents in order to enhance the residents’ independence and quality of life, in accordance with the company’s mission and values.
Physician Assistant (PA-C) / Nurse Practitioner - Primary Care Provider You Health Medical GroupPhysician Assistant (PA-C) / Nurse Practitioner - Primary Care ProviderDowney, California$133,000–$182,000div>About Us: Advanced Health Care Clinic: We are a Medical practice focused on preventative medicine, chronic disease management, and long-term patient relationships. Advanced Health Care Clinic - Huntington Park, CAPrimary Care Provider - Medical Clinic.NewRespite Care Provider Jovie of CA, WA, and MNRespite Care ProviderBurbank, CAul>Able to provide 3 references: 2 non-family childcare-related (paid or unpaid) and 1 character reference. Be in Charge – Manage safety, provide structure, and create fulfilling days that make a lasting impact.NewPrimary Care Provider, Nurse Practitioner / Physician Assistant Welbe Health LLCPrimary Care Provider, Nurse Practitioner / Physician AssistantNorth Hollywood, CA$150,009.60–$190,207.44 / yearp>At the direction of the Medical Director, the Primary Care Provider works collaboratively with WelbeHealth Physicians and the IDT to complete assessments, plan primary care, and educate WelbeHealth participants and their families. This role is different because Primary Care Providers at WelbeHealth: Serve a smaller patient caseload, providing the opportunity to form long-term relationships with participants and practice true value-based care.Respite Care Provider - Corona , Riverside Inland Respite Inc.Respite Care Provider - Corona , RiversideCorona, CaliforniaBy becoming a Respite Care Provider, you will give parents and families the chance to take a well-deserved break, whether it's to relax, run errands, or focus on their work, while ensuring their child remains engaged in safe, enjoyable, and functional activities within the comfort of their own home. At Inland Respite, Inc, our primary focus is on offering much-needed respite to families who are caring for children, teens, and adults on the Autism spectrum and other related developmental disabilities.Respite Care Provider - Victorville Inland Respite Inc.Respite Care Provider - VictorvilleVictorville, CaliforniaBy becoming a Respite Care Provider, you will give parents and families the chance to take a well-deserved break, whether it's to relax, run errands, or focus on their work, while ensuring their child remains engaged in safe, enjoyable, and functional activities within the comfort of their own home. At Inland Respite, Inc, our primary focus is on offering much-needed respite to families who are caring for children, teens, and adults on the Autism spectrum and other related developmental disabilities.NewHospital Provider (NP/PA) - Palliative Care Compass Palliative CareHospital Provider (NP/PA) - Palliative CareCorona, CaliforniaCompass Palliative Care, a leading California-based palliative care provider seeks outstanding Nurse Practitioners/ PAs who have experience and/or interest in palliative care. Our palliative program is run by experienced and board-certified physicians who take pride in being able to provide training and in-service education to their staff.Agency Respite Care Provider Aveanna Healthcare Holdings IncAgency Respite Care ProviderIrvine, CA$20–$24 / hourp>As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Requirements: Physical and mental ability to perform essential functions of the position; including but not limited to the ability to safely stoop and bend, lift, turn and transfer weight up to 50 pounds.Advanced Practice Provider (Nurse Practitioner / Physician Assistant) Primary Care / Family Practice EAST VALLEY COMMUNITY HEALTH CENTER INCAdvanced Practice Provider (Nurse Practitioner / Physician Assistant) Primary Care / Family PracticeWest Covina, CA$155,000–$183,038 / yearp>Work requires periods of standing, sitting, lifting, turning, twisting, walking, pushing, pulling, reaching, speaking, hearing, seeing and ability to articulate clearly, use of hands to finger, reaching with hands and arms. Provide additional medical services, as determined by Chief Medical Officer, within your scope of practice, such as Medication Assisted Therapy (MAT) or Pre-Exposure Prophylaxis (PrEP).Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)CARemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.Family Medicine Physician - Medical Provider / Primary Care TRITAL CareFamily Medicine Physician - Medical Provider / Primary CareBell, CAThe physician will evaluate, diagnose, treat, and manage patients across a broad range of primary care needs while supporting the organization’s mission to deliver compassionate, accessible, and culturally competent healthcare. A major Federally Qualified Health Center FQHC with multi-specialty outpatient community clinics across Los Angeles County is seeking dedicated, mission-oriented Family Medicine Physicians for permanent full-time opportunities.Respite Care Provider JovieRespite Care ProviderBurbank, CaliforniaThis is a wonderful opportunity to gain hands-on childcare experience while enjoying a flexible schedule that works for you. Able to provide 3 references: 2 non-family childcare-related (paid or unpaid) and 1 character reference.Advanced Practice Provider PA or NP Urgent Care American Family Care AnaheimAdvanced Practice Provider PA or NP Urgent CareAnaheim, Californiadiv> Responsibilities Perform complete, detailed, and accurate health histories, review patient records, develop comprehensive medical assessments, and order laboratory, radiological and diagnostic studies appropriate for complaint, race, sex, and physical condition of the patient. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient..NewProvider Enrollment Specialist AkidoProvider Enrollment SpecialistPomona, CA$24–$33 / hourp>Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from serving unhoused communities in Los Angeles to ride-share drivers in New York. Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal.Grievance Resolution Specialist (Provider Resolution) CalOptimaGrievance Resolution Specialist (Provider Resolution)Orange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Grievance Resolution Specialist (Provider Resolution) and help shape the future of healthcare where you'll be an integral part of our GA - Provider Disputes team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. High school diploma or equivalent PLUS 1 year of experience with Provider Dispute Resolution (PDR) in Medicare and Medi-Cal in professional, institutional, outpatient, ancillary, coordination of benefits and government cases required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Provider Relations | On-Site Newport Beach PrimeMSOSurgicalCentersProvider Relations | On-Site Newport BeachNewport Beach, CA$70,500 / yearWe have at least two company-wide events each year including Derby Days where all Prime staff are invited to attend a fully paid for trip to racing tracks on a race day and a Holiday party usually at an upscale restaurant in downtown LA. Our focus on building strategic relationships with our partners enables us to acquire, develop and optimize facilities in an aligned economic model that enables better access to high-quality care at a lower cost.Intensive Behavioral Support Provider Maxim Healthcare Services IncIntensive Behavioral Support ProviderWest Covina, CA$26–$29 / hourWe offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Maxim Healthcare in (insert location) is hiring for an Intensive Behavioral Support Provider to work with children and/or adults with developmental delays and challenging behaviors.Credentialing and Provider Enrollment Specialist Chaparral Medical GroupCredentialing and Provider Enrollment SpecialistPomona, CA$47,800–$66,650 / yearIn 2022, CMG joined forces with Akido Labs, a tech-enabled healthcare company, to transform the healthcare experience from the ground up. As part of the Akido medical network, we are currently responsible for more than 250,000 patients in Southern California, with plans to expand into new markets across the U.S. We care deeply about the communities we serve and are committed to providing accessible, high quality healthcare that helps our patients and communities live their fullest lives.Provider Enrollment Specialist II - Full Time Experity IncProvider Enrollment Specialist II - Full TimeCA$19.10–$22.50 / hourli>Flexibility - Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance. Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused.Provider Relations Manager Salma HealthProvider Relations ManagerLaguna Hills, Californiaul style="min-height:1.5em">Lead the development and optimization of high-impact referral partnerships with health systems, primary care providers (PCPs), psychiatrists, therapists, emergency departments, inpatient psychiatric units, PHPs, and outpatient behavioral health clinics. We are the brain health company of the future, integrating care delivery, technology innovation, and research breakthroughs to better understand brain biology and diagnose, treat, and ultimately cure brain disorders across all stages of life.Business Analytics Associate - Provider Contracting & Network Analytics - Remote The Cigna GroupBusiness Analytics Associate - Provider Contracting & Network Analytics - RemoteWork at Home, CARemote$79,000–$131,600 / yearIn this role, you will support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and execution of key initiatives designed to address unit cost and competitive discount. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.Hospital & Ancillary Provider Contracts Specialist AltaMed Health Services CorpHospital & Ancillary Provider Contracts SpecialistMontebello, CAThis role also involves mentoring junior staff, enhancing provider relationships, and driving efforts to secure new partnerships while maintaining strong collaboration with existing providers and clients. Bachelors degree in a related field with 4 years of relevant experience (i.e., provider contracting, contract interpretation, negotiation, client relations) or 5+ years of relevant experience in lieu of a degree.Direct Support Provider Maxim Healthcare Services IncDirect Support ProviderWest Covina, CA$22–$30 / hourOur commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities.Claims Specialist II - Provider Claims 26-00063 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00063Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.Claims Specialist II - Provider Claims 26-00106 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00106Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.NewAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness Event VitalCheck WellnessAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness EventAnaheim, CA$130–$130ul class="editor-list-ul">Set up and prepare the mobile clinic space within corporate environments to support employee wellness initiatives. A workplace wellness screening program is seeking a Spanish SpeakingProvider to provide onsite preventive wellness services within a professional workplace environment in Riverside, CA.Program Manager, Provider Data Operations CalOptimaProgram Manager, Provider Data OperationsOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Program Manager, Provider Data Operations and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree PLUS 3 years of experience in operations, data, project management and/or program management required, preferably in the health care industry or managed care environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Advanced Practice Provider - California Part-time Pacific Psychotherapy Technologies IncAdvanced Practice Provider - California Part-timeCARemote$62–$96 / hourSee tips from the FTC to avoid job scams: https://www.consumeraffairs.com/news/ftc-offers-tips-on-avoiding-job-scams-041321.html. Industry-best clinician experiences, better client outcomes, groundbreaking innovation, and access to the highest quality care are how we'll raise the bar for the entire industry.Driver / Medical Transportation Provider Provado HealthDriver / Medical Transportation ProviderSanta Ana, CAWe are seeking professional, punctual, polite, and responsible individuals to use their own vehicles to serve as independent Mobile Care Providers, driving members of select health plans to and from their dialysis appointments. In our Mobile Careforce, you have the freedom to work outside the office, and deliver a caring experience to people who need it outside the four walls of a medical facility or home.BH Associate Provider - Associate Clinical Social Worker Unicare Community Health Center IncBH Associate Provider - Associate Clinical Social WorkerOntario, CAp>Job Summary This associate clinical social worker will provide mental health and related services in a manner that upholds Unicare Community Health Center\u2019s mission to improve the health status and well-being of underserved segments of the population in the communities we serve through the direct provision or coordination of health care, health education, and services. Is engaged and facilitates outreach initiatives Proactively utilize clinical supervision and/or peer consultation Provide direct behavioral health and medical social work services to Latino individuals, families, groups and communities, under the supervision of the Director of Behavioral Health.VP, Provider and Member Appeals & Grievances Alignment Healthcare IncVP, Provider and Member Appeals & GrievancesCA$227,952–$341,928 / yearp>Operating at the intersection of regulatory compliance, operational excellence, and member experi-ence, this leader is responsible for building and sustaining a high-performing, multi-layered leadership organization that drives Caring Connections, proactively manages compliance risk, and delivers meas-urable improvement across quality, timeliness, and member and provider outcomes. Job Requirements: Experience: Required: 10+ years of progressive leadership experience in appeals, grievances, utilization management, or health plan regulatory operations, including at least 5 years in a senior leadership role overseeing a multi-functional team in a Medicare Advantage or Health Insurance environment.Provider Relations Manager Inland Empire Health PlanProvider Relations ManagerRancho Cucamonga, CAIt's not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it's something that I'm profoundly proud of because I know that I'm making a difference. Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me.NewBusiness Analyst Sr, Provider Data Operations - Covered California CalOptimaBusiness Analyst Sr, Provider Data Operations - Covered CaliforniaOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Business Analyst Sr, Provider Data Operations - Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree in business administration, management, data science or related field PLUS 3 years of experience in health care operations, provider data management, system implementation or gathering of business requirements required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Provider Data Management Services Coordinator Sr, Covered California CalOptimaProvider Data Management Services Coordinator Sr, Covered CaliforniaOrange, CA$55,966–$83,949 / yearp>We are hoping you will join us as a Provider Data Management Services Coordinator Sr, Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. The Provider Data Management Services Coordinator Sr will be responsible for building, updating and maintaining provider records and data in the CalOptima Health provider system and function as a liaison between the health networks and providers to ensure the accuracy and completeness of provider data as reflected in CalOptima Health's databases, systems and provider directory.Provider Relations Manager I ModivCare Inc.Provider Relations Manager IOrange, CA$52,900–$71,400 / yearp>This position is responsible for developing and maintaining positive and effective working relationships with transportation providers within specific geographic areas, various company departments, and outside resources as requested. Drives performance in key metrics (safety, on-time delivery/pickup, reroutes, and compliance) and provider performance against Perfect Trip expectations (Trip acceptance, On Time to pick/depart, On Time to Destination, Digital Compliance, Reroutes and Complaints).Provider - Family Medicine Physician Unicare Community Health Center IncProvider - Family Medicine PhysicianFontana, CAp>Medical Degree (MD, DO) A minimum of 3 years of Family Practice Residency training A minimum of two (2) years\u2019 experience in public health; Thorough knowledge of principles and practices of modem medicine related to public health services and general knowledge of state and federal laws pertaining to public health; Excellent verbal and written communication skills, including strong organizational, detail and interpersonal skills; Basic computer skills and knowledge, including Microsoft Office and familiar with Electronic Health Records (EHR); Training, Education and Licensure: CA Medical License, DEA Certificate BSL certified Board-Certified or Board-Eligible in Family Medicine. Services include: Preventative care, immunizations, primary care and treatment, health education, prescribing of medications, ordering and interpreting lab testing, physical examinations, STD screenings, Vision/hearing, women\u2019s health, family planning, prenatal services, nutrition.Provider Network Management Associate Welbe Health LLCProvider Network Management AssociateRosemead, CA$82,074.03–$108,337.72 / yearThis role is different because Provider Network Management Associates at WelbeHealth: Have an opportunity to build and shape a highly integrated provider network strategy within a mission-driven PACE model, where clinical outcomes, member experience, and community-based care are deeply interconnected. Work in a role that offers direct influence on holistic care delivery for a vulnerable senior population through cross-functional partnership and innovative care models, unlike traditional network strategy roles focused primarily on contracting and cost management.Account Director - CE&I Energy Providers Guidehouse IncAccount Director - CE&I Energy Providerslos angeles, CA$197,000–$328,000 / yearBachelor's degree in engineering, business or related discipline AND Ten (10+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications); Or Master's degree in engineering, business or related discipline AND Eight (8+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications). Successful experience leading business development initiatives (writing proposals, identifying opportunities to expand the scope, and/or providing additional services) and managing account teams (developing and implementing an account plan and leading account team activities).Provider Contracting Coordinator Astrana Health IncProvider Contracting CoordinatorMonterey Park, CAThis role will report to the Provider Contracting Manager and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Contracting Coordinator.Inpatient Palliative Provider Senior DocInpatient Palliative ProviderIrvine, CAdiv class="content-pay-transparency">Hourly range for posted region$85—$120 USD Senior Doc, part of Brigade Health, is seeking a compassionate Nurse Practitioner or Physician Assistant to join our growing Inpatient Palliative Care team.Provider Service Representative UnitedHealth Group IncProvider Service RepresentativeOntario, CA$18–$32 / hourp>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. 3+ years of managed care or medical insurance experience with provider network management (to include provider claims, credentialing, contract documentation and configuration processing required.NewProvider Relations Coordinator UnitedHealth Group IncProvider Relations CoordinatorIrvine, CA$20–$36 / hourp>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities: Under the supervision of the VP, Government Programs and in collaboration with other stakeholders, the Quality Performance Coordinator will implement data-driven strategies and workplans that improve the overall health and service provided to our Medi-Cal patients.Sr Director, Provider Data Management SHPCA SCAN Health PlanSr Director, Provider Data ManagementLong Beach, Californiaa href="http://www.scanhealthplan.com/" rel="nofollow noopener noreferrer" target="_blank">www.scanhealthplan.com, or follow us on LinkedIn; Facebook; and Twitter. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.Claims Specialist II - Provider Claims 26-00130 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00130Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.Provider Liaison Manager Infusion for HealthProvider Liaison ManagerBrea, CAp>We are seeking a Provider Liaison Manager to lead and scale a high-performing team of Provider Liaisons responsible for driving referral growth, patient retention, patient conversion, and strengthening provider relationships. This role sits at the intersection of business development, inside sales, and patient operations, ensuring that referral pipelines are robust, provider partners are engaged, and operational barriers are resolved quickly.Provider Quality Review Nurse, RN Inland Empire Health PlanProvider Quality Review Nurse, RNRancho Cucamonga, CAul>Three (3) or more years of any individual or combined healthcare experience in quality assurance, quality management, quality improvement, utilization management, discharge planning, and/or case management. Certified Professional in Healthcare Quality (CPHQ), Certified Professional in Healthcare Risk Management (CPHRM), or Clinical certification in area specialty) preferred.Provider Network Specialist (San Fernando Valley) Astrana Health, Inc.Provider Network Specialist (San Fernando Valley)El Monte, CA$70,304–$80,000 / yearThe Provider Network Specialist plays a critical role in ensuring provider data accuracy, network access, compliance, and provider satisfaction while supporting membership growth and quality outcomes. This role is responsible for coordinating provider lifecycle activities, supporting network performance initiatives, and serving as a key operational liaison between providers and internal departments.NewStudent Intern - Provider Relations - Part time - Temporary Providence Health & ServicesStudent Intern - Provider Relations - Part time - TemporaryAnaheim, CA$15.98–$23.65 / hourp>Requsition ID: 440583 Company: Providence Jobs Job Category: Academics Job Function: Administration Job Schedule: Part time Job Shift: Day Career Track: Business Professional Department: 7520 PROVIDER RELATIONS CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: Hybrid Pay Range: $15.98 - $23.65 High Performing Network (HN) is looking for a graduate student resident to gain healthcare workplace experience by providing the intern opportunities to carry out specific projects and processes with the support and direction of staff in health network operations.12345Similar Job SearchesActivities Assistant JobsActivities Director JobsActivity Director JobsCare Advocate JobsCare Coordinator JobsCare Manager JobsCaregiver JobsCase Manager JobsCommunity Health Worker JobsDirect Support Professional Jobs
NewRespite Care Provider Jovie of CA, WA, and MNRespite Care ProviderBurbank, CAul>Able to provide 3 references: 2 non-family childcare-related (paid or unpaid) and 1 character reference. Be in Charge – Manage safety, provide structure, and create fulfilling days that make a lasting impact.
NewPrimary Care Provider, Nurse Practitioner / Physician Assistant Welbe Health LLCPrimary Care Provider, Nurse Practitioner / Physician AssistantNorth Hollywood, CA$150,009.60–$190,207.44 / yearp>At the direction of the Medical Director, the Primary Care Provider works collaboratively with WelbeHealth Physicians and the IDT to complete assessments, plan primary care, and educate WelbeHealth participants and their families. This role is different because Primary Care Providers at WelbeHealth: Serve a smaller patient caseload, providing the opportunity to form long-term relationships with participants and practice true value-based care.
Respite Care Provider - Corona , Riverside Inland Respite Inc.Respite Care Provider - Corona , RiversideCorona, CaliforniaBy becoming a Respite Care Provider, you will give parents and families the chance to take a well-deserved break, whether it's to relax, run errands, or focus on their work, while ensuring their child remains engaged in safe, enjoyable, and functional activities within the comfort of their own home. At Inland Respite, Inc, our primary focus is on offering much-needed respite to families who are caring for children, teens, and adults on the Autism spectrum and other related developmental disabilities.
Respite Care Provider - Victorville Inland Respite Inc.Respite Care Provider - VictorvilleVictorville, CaliforniaBy becoming a Respite Care Provider, you will give parents and families the chance to take a well-deserved break, whether it's to relax, run errands, or focus on their work, while ensuring their child remains engaged in safe, enjoyable, and functional activities within the comfort of their own home. At Inland Respite, Inc, our primary focus is on offering much-needed respite to families who are caring for children, teens, and adults on the Autism spectrum and other related developmental disabilities.
NewHospital Provider (NP/PA) - Palliative Care Compass Palliative CareHospital Provider (NP/PA) - Palliative CareCorona, CaliforniaCompass Palliative Care, a leading California-based palliative care provider seeks outstanding Nurse Practitioners/ PAs who have experience and/or interest in palliative care. Our palliative program is run by experienced and board-certified physicians who take pride in being able to provide training and in-service education to their staff.
Agency Respite Care Provider Aveanna Healthcare Holdings IncAgency Respite Care ProviderIrvine, CA$20–$24 / hourp>As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Requirements: Physical and mental ability to perform essential functions of the position; including but not limited to the ability to safely stoop and bend, lift, turn and transfer weight up to 50 pounds.
Advanced Practice Provider (Nurse Practitioner / Physician Assistant) Primary Care / Family Practice EAST VALLEY COMMUNITY HEALTH CENTER INCAdvanced Practice Provider (Nurse Practitioner / Physician Assistant) Primary Care / Family PracticeWest Covina, CA$155,000–$183,038 / yearp>Work requires periods of standing, sitting, lifting, turning, twisting, walking, pushing, pulling, reaching, speaking, hearing, seeing and ability to articulate clearly, use of hands to finger, reaching with hands and arms. Provide additional medical services, as determined by Chief Medical Officer, within your scope of practice, such as Medication Assisted Therapy (MAT) or Pre-Exposure Prophylaxis (PrEP).
Transitions of Care Advanced Practice Provider (APP) Devoted Health IncTransitions of Care Advanced Practice Provider (APP)CARemoteAdditional requirements include completing a post-discharge medication reconciliation, placing appropriate orders (prescriptions, labs, imaging, referrals, home health, DME), providing appropriate disease education, communicating contingency plans for worsening symptoms, and comprehensively assessing a patient's medical conditions. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.
Family Medicine Physician - Medical Provider / Primary Care TRITAL CareFamily Medicine Physician - Medical Provider / Primary CareBell, CAThe physician will evaluate, diagnose, treat, and manage patients across a broad range of primary care needs while supporting the organization’s mission to deliver compassionate, accessible, and culturally competent healthcare. A major Federally Qualified Health Center FQHC with multi-specialty outpatient community clinics across Los Angeles County is seeking dedicated, mission-oriented Family Medicine Physicians for permanent full-time opportunities.
Respite Care Provider JovieRespite Care ProviderBurbank, CaliforniaThis is a wonderful opportunity to gain hands-on childcare experience while enjoying a flexible schedule that works for you. Able to provide 3 references: 2 non-family childcare-related (paid or unpaid) and 1 character reference.
Advanced Practice Provider PA or NP Urgent Care American Family Care AnaheimAdvanced Practice Provider PA or NP Urgent CareAnaheim, Californiadiv> Responsibilities Perform complete, detailed, and accurate health histories, review patient records, develop comprehensive medical assessments, and order laboratory, radiological and diagnostic studies appropriate for complaint, race, sex, and physical condition of the patient. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient..
NewProvider Enrollment Specialist AkidoProvider Enrollment SpecialistPomona, CA$24–$33 / hourp>Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from serving unhoused communities in Los Angeles to ride-share drivers in New York. Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal.Grievance Resolution Specialist (Provider Resolution) CalOptimaGrievance Resolution Specialist (Provider Resolution)Orange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Grievance Resolution Specialist (Provider Resolution) and help shape the future of healthcare where you'll be an integral part of our GA - Provider Disputes team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. High school diploma or equivalent PLUS 1 year of experience with Provider Dispute Resolution (PDR) in Medicare and Medi-Cal in professional, institutional, outpatient, ancillary, coordination of benefits and government cases required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Provider Relations | On-Site Newport Beach PrimeMSOSurgicalCentersProvider Relations | On-Site Newport BeachNewport Beach, CA$70,500 / yearWe have at least two company-wide events each year including Derby Days where all Prime staff are invited to attend a fully paid for trip to racing tracks on a race day and a Holiday party usually at an upscale restaurant in downtown LA. Our focus on building strategic relationships with our partners enables us to acquire, develop and optimize facilities in an aligned economic model that enables better access to high-quality care at a lower cost.Intensive Behavioral Support Provider Maxim Healthcare Services IncIntensive Behavioral Support ProviderWest Covina, CA$26–$29 / hourWe offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Maxim Healthcare in (insert location) is hiring for an Intensive Behavioral Support Provider to work with children and/or adults with developmental delays and challenging behaviors.Credentialing and Provider Enrollment Specialist Chaparral Medical GroupCredentialing and Provider Enrollment SpecialistPomona, CA$47,800–$66,650 / yearIn 2022, CMG joined forces with Akido Labs, a tech-enabled healthcare company, to transform the healthcare experience from the ground up. As part of the Akido medical network, we are currently responsible for more than 250,000 patients in Southern California, with plans to expand into new markets across the U.S. We care deeply about the communities we serve and are committed to providing accessible, high quality healthcare that helps our patients and communities live their fullest lives.Provider Enrollment Specialist II - Full Time Experity IncProvider Enrollment Specialist II - Full TimeCA$19.10–$22.50 / hourli>Flexibility - Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance. Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused.Provider Relations Manager Salma HealthProvider Relations ManagerLaguna Hills, Californiaul style="min-height:1.5em">Lead the development and optimization of high-impact referral partnerships with health systems, primary care providers (PCPs), psychiatrists, therapists, emergency departments, inpatient psychiatric units, PHPs, and outpatient behavioral health clinics. We are the brain health company of the future, integrating care delivery, technology innovation, and research breakthroughs to better understand brain biology and diagnose, treat, and ultimately cure brain disorders across all stages of life.Business Analytics Associate - Provider Contracting & Network Analytics - Remote The Cigna GroupBusiness Analytics Associate - Provider Contracting & Network Analytics - RemoteWork at Home, CARemote$79,000–$131,600 / yearIn this role, you will support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and execution of key initiatives designed to address unit cost and competitive discount. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.Hospital & Ancillary Provider Contracts Specialist AltaMed Health Services CorpHospital & Ancillary Provider Contracts SpecialistMontebello, CAThis role also involves mentoring junior staff, enhancing provider relationships, and driving efforts to secure new partnerships while maintaining strong collaboration with existing providers and clients. Bachelors degree in a related field with 4 years of relevant experience (i.e., provider contracting, contract interpretation, negotiation, client relations) or 5+ years of relevant experience in lieu of a degree.Direct Support Provider Maxim Healthcare Services IncDirect Support ProviderWest Covina, CA$22–$30 / hourOur commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities.Claims Specialist II - Provider Claims 26-00063 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00063Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.Claims Specialist II - Provider Claims 26-00106 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00106Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.NewAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness Event VitalCheck WellnessAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness EventAnaheim, CA$130–$130ul class="editor-list-ul">Set up and prepare the mobile clinic space within corporate environments to support employee wellness initiatives. A workplace wellness screening program is seeking a Spanish SpeakingProvider to provide onsite preventive wellness services within a professional workplace environment in Riverside, CA.Program Manager, Provider Data Operations CalOptimaProgram Manager, Provider Data OperationsOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Program Manager, Provider Data Operations and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree PLUS 3 years of experience in operations, data, project management and/or program management required, preferably in the health care industry or managed care environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Advanced Practice Provider - California Part-time Pacific Psychotherapy Technologies IncAdvanced Practice Provider - California Part-timeCARemote$62–$96 / hourSee tips from the FTC to avoid job scams: https://www.consumeraffairs.com/news/ftc-offers-tips-on-avoiding-job-scams-041321.html. Industry-best clinician experiences, better client outcomes, groundbreaking innovation, and access to the highest quality care are how we'll raise the bar for the entire industry.Driver / Medical Transportation Provider Provado HealthDriver / Medical Transportation ProviderSanta Ana, CAWe are seeking professional, punctual, polite, and responsible individuals to use their own vehicles to serve as independent Mobile Care Providers, driving members of select health plans to and from their dialysis appointments. In our Mobile Careforce, you have the freedom to work outside the office, and deliver a caring experience to people who need it outside the four walls of a medical facility or home.BH Associate Provider - Associate Clinical Social Worker Unicare Community Health Center IncBH Associate Provider - Associate Clinical Social WorkerOntario, CAp>Job Summary This associate clinical social worker will provide mental health and related services in a manner that upholds Unicare Community Health Center\u2019s mission to improve the health status and well-being of underserved segments of the population in the communities we serve through the direct provision or coordination of health care, health education, and services. Is engaged and facilitates outreach initiatives Proactively utilize clinical supervision and/or peer consultation Provide direct behavioral health and medical social work services to Latino individuals, families, groups and communities, under the supervision of the Director of Behavioral Health.VP, Provider and Member Appeals & Grievances Alignment Healthcare IncVP, Provider and Member Appeals & GrievancesCA$227,952–$341,928 / yearp>Operating at the intersection of regulatory compliance, operational excellence, and member experi-ence, this leader is responsible for building and sustaining a high-performing, multi-layered leadership organization that drives Caring Connections, proactively manages compliance risk, and delivers meas-urable improvement across quality, timeliness, and member and provider outcomes. Job Requirements: Experience: Required: 10+ years of progressive leadership experience in appeals, grievances, utilization management, or health plan regulatory operations, including at least 5 years in a senior leadership role overseeing a multi-functional team in a Medicare Advantage or Health Insurance environment.Provider Relations Manager Inland Empire Health PlanProvider Relations ManagerRancho Cucamonga, CAIt's not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it's something that I'm profoundly proud of because I know that I'm making a difference. Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me.NewBusiness Analyst Sr, Provider Data Operations - Covered California CalOptimaBusiness Analyst Sr, Provider Data Operations - Covered CaliforniaOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Business Analyst Sr, Provider Data Operations - Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree in business administration, management, data science or related field PLUS 3 years of experience in health care operations, provider data management, system implementation or gathering of business requirements required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Provider Data Management Services Coordinator Sr, Covered California CalOptimaProvider Data Management Services Coordinator Sr, Covered CaliforniaOrange, CA$55,966–$83,949 / yearp>We are hoping you will join us as a Provider Data Management Services Coordinator Sr, Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. The Provider Data Management Services Coordinator Sr will be responsible for building, updating and maintaining provider records and data in the CalOptima Health provider system and function as a liaison between the health networks and providers to ensure the accuracy and completeness of provider data as reflected in CalOptima Health's databases, systems and provider directory.Provider Relations Manager I ModivCare Inc.Provider Relations Manager IOrange, CA$52,900–$71,400 / yearp>This position is responsible for developing and maintaining positive and effective working relationships with transportation providers within specific geographic areas, various company departments, and outside resources as requested. Drives performance in key metrics (safety, on-time delivery/pickup, reroutes, and compliance) and provider performance against Perfect Trip expectations (Trip acceptance, On Time to pick/depart, On Time to Destination, Digital Compliance, Reroutes and Complaints).Provider - Family Medicine Physician Unicare Community Health Center IncProvider - Family Medicine PhysicianFontana, CAp>Medical Degree (MD, DO) A minimum of 3 years of Family Practice Residency training A minimum of two (2) years\u2019 experience in public health; Thorough knowledge of principles and practices of modem medicine related to public health services and general knowledge of state and federal laws pertaining to public health; Excellent verbal and written communication skills, including strong organizational, detail and interpersonal skills; Basic computer skills and knowledge, including Microsoft Office and familiar with Electronic Health Records (EHR); Training, Education and Licensure: CA Medical License, DEA Certificate BSL certified Board-Certified or Board-Eligible in Family Medicine. Services include: Preventative care, immunizations, primary care and treatment, health education, prescribing of medications, ordering and interpreting lab testing, physical examinations, STD screenings, Vision/hearing, women\u2019s health, family planning, prenatal services, nutrition.Provider Network Management Associate Welbe Health LLCProvider Network Management AssociateRosemead, CA$82,074.03–$108,337.72 / yearThis role is different because Provider Network Management Associates at WelbeHealth: Have an opportunity to build and shape a highly integrated provider network strategy within a mission-driven PACE model, where clinical outcomes, member experience, and community-based care are deeply interconnected. Work in a role that offers direct influence on holistic care delivery for a vulnerable senior population through cross-functional partnership and innovative care models, unlike traditional network strategy roles focused primarily on contracting and cost management.Account Director - CE&I Energy Providers Guidehouse IncAccount Director - CE&I Energy Providerslos angeles, CA$197,000–$328,000 / yearBachelor's degree in engineering, business or related discipline AND Ten (10+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications); Or Master's degree in engineering, business or related discipline AND Eight (8+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications). Successful experience leading business development initiatives (writing proposals, identifying opportunities to expand the scope, and/or providing additional services) and managing account teams (developing and implementing an account plan and leading account team activities).Provider Contracting Coordinator Astrana Health IncProvider Contracting CoordinatorMonterey Park, CAThis role will report to the Provider Contracting Manager and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Contracting Coordinator.Inpatient Palliative Provider Senior DocInpatient Palliative ProviderIrvine, CAdiv class="content-pay-transparency">Hourly range for posted region$85—$120 USD Senior Doc, part of Brigade Health, is seeking a compassionate Nurse Practitioner or Physician Assistant to join our growing Inpatient Palliative Care team.
Grievance Resolution Specialist (Provider Resolution) CalOptimaGrievance Resolution Specialist (Provider Resolution)Orange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Grievance Resolution Specialist (Provider Resolution) and help shape the future of healthcare where you'll be an integral part of our GA - Provider Disputes team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. High school diploma or equivalent PLUS 1 year of experience with Provider Dispute Resolution (PDR) in Medicare and Medi-Cal in professional, institutional, outpatient, ancillary, coordination of benefits and government cases required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Provider Relations | On-Site Newport Beach PrimeMSOSurgicalCentersProvider Relations | On-Site Newport BeachNewport Beach, CA$70,500 / yearWe have at least two company-wide events each year including Derby Days where all Prime staff are invited to attend a fully paid for trip to racing tracks on a race day and a Holiday party usually at an upscale restaurant in downtown LA. Our focus on building strategic relationships with our partners enables us to acquire, develop and optimize facilities in an aligned economic model that enables better access to high-quality care at a lower cost.
Intensive Behavioral Support Provider Maxim Healthcare Services IncIntensive Behavioral Support ProviderWest Covina, CA$26–$29 / hourWe offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Maxim Healthcare in (insert location) is hiring for an Intensive Behavioral Support Provider to work with children and/or adults with developmental delays and challenging behaviors.
Credentialing and Provider Enrollment Specialist Chaparral Medical GroupCredentialing and Provider Enrollment SpecialistPomona, CA$47,800–$66,650 / yearIn 2022, CMG joined forces with Akido Labs, a tech-enabled healthcare company, to transform the healthcare experience from the ground up. As part of the Akido medical network, we are currently responsible for more than 250,000 patients in Southern California, with plans to expand into new markets across the U.S. We care deeply about the communities we serve and are committed to providing accessible, high quality healthcare that helps our patients and communities live their fullest lives.
Provider Enrollment Specialist II - Full Time Experity IncProvider Enrollment Specialist II - Full TimeCA$19.10–$22.50 / hourli>Flexibility - Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance. Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused.
Provider Relations Manager Salma HealthProvider Relations ManagerLaguna Hills, Californiaul style="min-height:1.5em">Lead the development and optimization of high-impact referral partnerships with health systems, primary care providers (PCPs), psychiatrists, therapists, emergency departments, inpatient psychiatric units, PHPs, and outpatient behavioral health clinics. We are the brain health company of the future, integrating care delivery, technology innovation, and research breakthroughs to better understand brain biology and diagnose, treat, and ultimately cure brain disorders across all stages of life.
Business Analytics Associate - Provider Contracting & Network Analytics - Remote The Cigna GroupBusiness Analytics Associate - Provider Contracting & Network Analytics - RemoteWork at Home, CARemote$79,000–$131,600 / yearIn this role, you will support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and execution of key initiatives designed to address unit cost and competitive discount. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Hospital & Ancillary Provider Contracts Specialist AltaMed Health Services CorpHospital & Ancillary Provider Contracts SpecialistMontebello, CAThis role also involves mentoring junior staff, enhancing provider relationships, and driving efforts to secure new partnerships while maintaining strong collaboration with existing providers and clients. Bachelors degree in a related field with 4 years of relevant experience (i.e., provider contracting, contract interpretation, negotiation, client relations) or 5+ years of relevant experience in lieu of a degree.
Direct Support Provider Maxim Healthcare Services IncDirect Support ProviderWest Covina, CA$22–$30 / hourOur commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities.
Claims Specialist II - Provider Claims 26-00063 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00063Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00106 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00106Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
NewAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness Event VitalCheck WellnessAdvanced Practice Provider (Bilingual Spanish Speaking) | Employee Wellness EventAnaheim, CA$130–$130ul class="editor-list-ul">Set up and prepare the mobile clinic space within corporate environments to support employee wellness initiatives. A workplace wellness screening program is seeking a Spanish SpeakingProvider to provide onsite preventive wellness services within a professional workplace environment in Riverside, CA.
Program Manager, Provider Data Operations CalOptimaProgram Manager, Provider Data OperationsOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Program Manager, Provider Data Operations and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree PLUS 3 years of experience in operations, data, project management and/or program management required, preferably in the health care industry or managed care environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Advanced Practice Provider - California Part-time Pacific Psychotherapy Technologies IncAdvanced Practice Provider - California Part-timeCARemote$62–$96 / hourSee tips from the FTC to avoid job scams: https://www.consumeraffairs.com/news/ftc-offers-tips-on-avoiding-job-scams-041321.html. Industry-best clinician experiences, better client outcomes, groundbreaking innovation, and access to the highest quality care are how we'll raise the bar for the entire industry.
Driver / Medical Transportation Provider Provado HealthDriver / Medical Transportation ProviderSanta Ana, CAWe are seeking professional, punctual, polite, and responsible individuals to use their own vehicles to serve as independent Mobile Care Providers, driving members of select health plans to and from their dialysis appointments. In our Mobile Careforce, you have the freedom to work outside the office, and deliver a caring experience to people who need it outside the four walls of a medical facility or home.
BH Associate Provider - Associate Clinical Social Worker Unicare Community Health Center IncBH Associate Provider - Associate Clinical Social WorkerOntario, CAp>Job Summary This associate clinical social worker will provide mental health and related services in a manner that upholds Unicare Community Health Center\u2019s mission to improve the health status and well-being of underserved segments of the population in the communities we serve through the direct provision or coordination of health care, health education, and services. Is engaged and facilitates outreach initiatives Proactively utilize clinical supervision and/or peer consultation Provide direct behavioral health and medical social work services to Latino individuals, families, groups and communities, under the supervision of the Director of Behavioral Health.
VP, Provider and Member Appeals & Grievances Alignment Healthcare IncVP, Provider and Member Appeals & GrievancesCA$227,952–$341,928 / yearp>Operating at the intersection of regulatory compliance, operational excellence, and member experi-ence, this leader is responsible for building and sustaining a high-performing, multi-layered leadership organization that drives Caring Connections, proactively manages compliance risk, and delivers meas-urable improvement across quality, timeliness, and member and provider outcomes. Job Requirements: Experience: Required: 10+ years of progressive leadership experience in appeals, grievances, utilization management, or health plan regulatory operations, including at least 5 years in a senior leadership role overseeing a multi-functional team in a Medicare Advantage or Health Insurance environment.
Provider Relations Manager Inland Empire Health PlanProvider Relations ManagerRancho Cucamonga, CAIt's not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it's something that I'm profoundly proud of because I know that I'm making a difference. Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me.
NewBusiness Analyst Sr, Provider Data Operations - Covered California CalOptimaBusiness Analyst Sr, Provider Data Operations - Covered CaliforniaOrange, CA$77,863–$124,581 / yearp>We are hoping you will join us as a Business Analyst Sr, Provider Data Operations - Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree in business administration, management, data science or related field PLUS 3 years of experience in health care operations, provider data management, system implementation or gathering of business requirements required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Provider Data Management Services Coordinator Sr, Covered California CalOptimaProvider Data Management Services Coordinator Sr, Covered CaliforniaOrange, CA$55,966–$83,949 / yearp>We are hoping you will join us as a Provider Data Management Services Coordinator Sr, Covered California and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. The Provider Data Management Services Coordinator Sr will be responsible for building, updating and maintaining provider records and data in the CalOptima Health provider system and function as a liaison between the health networks and providers to ensure the accuracy and completeness of provider data as reflected in CalOptima Health's databases, systems and provider directory.
Provider Relations Manager I ModivCare Inc.Provider Relations Manager IOrange, CA$52,900–$71,400 / yearp>This position is responsible for developing and maintaining positive and effective working relationships with transportation providers within specific geographic areas, various company departments, and outside resources as requested. Drives performance in key metrics (safety, on-time delivery/pickup, reroutes, and compliance) and provider performance against Perfect Trip expectations (Trip acceptance, On Time to pick/depart, On Time to Destination, Digital Compliance, Reroutes and Complaints).
Provider - Family Medicine Physician Unicare Community Health Center IncProvider - Family Medicine PhysicianFontana, CAp>Medical Degree (MD, DO) A minimum of 3 years of Family Practice Residency training A minimum of two (2) years\u2019 experience in public health; Thorough knowledge of principles and practices of modem medicine related to public health services and general knowledge of state and federal laws pertaining to public health; Excellent verbal and written communication skills, including strong organizational, detail and interpersonal skills; Basic computer skills and knowledge, including Microsoft Office and familiar with Electronic Health Records (EHR); Training, Education and Licensure: CA Medical License, DEA Certificate BSL certified Board-Certified or Board-Eligible in Family Medicine. Services include: Preventative care, immunizations, primary care and treatment, health education, prescribing of medications, ordering and interpreting lab testing, physical examinations, STD screenings, Vision/hearing, women\u2019s health, family planning, prenatal services, nutrition.
Provider Network Management Associate Welbe Health LLCProvider Network Management AssociateRosemead, CA$82,074.03–$108,337.72 / yearThis role is different because Provider Network Management Associates at WelbeHealth: Have an opportunity to build and shape a highly integrated provider network strategy within a mission-driven PACE model, where clinical outcomes, member experience, and community-based care are deeply interconnected. Work in a role that offers direct influence on holistic care delivery for a vulnerable senior population through cross-functional partnership and innovative care models, unlike traditional network strategy roles focused primarily on contracting and cost management.
Account Director - CE&I Energy Providers Guidehouse IncAccount Director - CE&I Energy Providerslos angeles, CA$197,000–$328,000 / yearBachelor's degree in engineering, business or related discipline AND Ten (10+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications); Or Master's degree in engineering, business or related discipline AND Eight (8+) plus years' management consulting experience within power utilities (excluding Oil & Gas or Telecommunications). Successful experience leading business development initiatives (writing proposals, identifying opportunities to expand the scope, and/or providing additional services) and managing account teams (developing and implementing an account plan and leading account team activities).
Provider Contracting Coordinator Astrana Health IncProvider Contracting CoordinatorMonterey Park, CAThis role will report to the Provider Contracting Manager and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Contracting Coordinator.
Inpatient Palliative Provider Senior DocInpatient Palliative ProviderIrvine, CAdiv class="content-pay-transparency">Hourly range for posted region$85—$120 USD Senior Doc, part of Brigade Health, is seeking a compassionate Nurse Practitioner or Physician Assistant to join our growing Inpatient Palliative Care team.
Provider Service Representative UnitedHealth Group IncProvider Service RepresentativeOntario, CA$18–$32 / hourp>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. 3+ years of managed care or medical insurance experience with provider network management (to include provider claims, credentialing, contract documentation and configuration processing required.
NewProvider Relations Coordinator UnitedHealth Group IncProvider Relations CoordinatorIrvine, CA$20–$36 / hourp>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities: Under the supervision of the VP, Government Programs and in collaboration with other stakeholders, the Quality Performance Coordinator will implement data-driven strategies and workplans that improve the overall health and service provided to our Medi-Cal patients.
Sr Director, Provider Data Management SHPCA SCAN Health PlanSr Director, Provider Data ManagementLong Beach, Californiaa href="http://www.scanhealthplan.com/" rel="nofollow noopener noreferrer" target="_blank">www.scanhealthplan.com, or follow us on LinkedIn; Facebook; and Twitter. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Claims Specialist II - Provider Claims 26-00130 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00130Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Provider Liaison Manager Infusion for HealthProvider Liaison ManagerBrea, CAp>We are seeking a Provider Liaison Manager to lead and scale a high-performing team of Provider Liaisons responsible for driving referral growth, patient retention, patient conversion, and strengthening provider relationships. This role sits at the intersection of business development, inside sales, and patient operations, ensuring that referral pipelines are robust, provider partners are engaged, and operational barriers are resolved quickly.
Provider Quality Review Nurse, RN Inland Empire Health PlanProvider Quality Review Nurse, RNRancho Cucamonga, CAul>Three (3) or more years of any individual or combined healthcare experience in quality assurance, quality management, quality improvement, utilization management, discharge planning, and/or case management. Certified Professional in Healthcare Quality (CPHQ), Certified Professional in Healthcare Risk Management (CPHRM), or Clinical certification in area specialty) preferred.
Provider Network Specialist (San Fernando Valley) Astrana Health, Inc.Provider Network Specialist (San Fernando Valley)El Monte, CA$70,304–$80,000 / yearThe Provider Network Specialist plays a critical role in ensuring provider data accuracy, network access, compliance, and provider satisfaction while supporting membership growth and quality outcomes. This role is responsible for coordinating provider lifecycle activities, supporting network performance initiatives, and serving as a key operational liaison between providers and internal departments.
NewStudent Intern - Provider Relations - Part time - Temporary Providence Health & ServicesStudent Intern - Provider Relations - Part time - TemporaryAnaheim, CA$15.98–$23.65 / hourp>Requsition ID: 440583 Company: Providence Jobs Job Category: Academics Job Function: Administration Job Schedule: Part time Job Shift: Day Career Track: Business Professional Department: 7520 PROVIDER RELATIONS CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: Hybrid Pay Range: $15.98 - $23.65 High Performing Network (HN) is looking for a graduate student resident to gain healthcare workplace experience by providing the intern opportunities to carry out specific projects and processes with the support and direction of staff in health network operations.