UNKNOWN

FEED

Facilitates individuals' health system navigation and the receipt of needed medical services, improves individual's self-management and overall health Astiva Health, Inc. and functioning, coordinates care among multiple providers, and mitigates medical risk (reduces hospitalization, readmission and ED visit rates and lowers healthcare costs). The primary objective of the Ambulatory Case Manager (ACM) is to work within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation in accordance with the Model of Care and CMS regulations.

YEAR

Astiva Health

Case Manager

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Involve in the early stages of practice development activities including developing a professional network or referral sources, assisting in proposals, or writing articles for publication and assisting partners in their practice development activities. Manage SOX 404 and Internal Audit engagement(s) and workflow of all client deliverables for multiple clients and engagements to minimize risk and surprises, optimize engagement economics, satisfy service objectives, and meet internal and external deadlines.

Armanino McKenna Certified Public Accountants & Consultants

Senior Manager, Business SOX IA

As drones transform the character of warfare, Neros is delivering the systems the West needs to compete on the modern battlefield and deter the adversaries of democracy. We design and manufacture high-performance unmanned systems that are tested in combat, iterated at startup speed, and built at massive scale.

Neros Technologies

Media Relations Manager

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Coordinate communication and external service linkage including assisting with scheduling appointments, communicating with probation, scheduling child visits, communicating with DCFS, obtaining all court minute orders, providing appointment reminders for therapy and psychiatrist. Prototypes Women's Center in Pomona is a 180-bed residential facility tailored specifically to women, including those who wish to involve their children in their journey to recovery.

Healthright 360

Case Manager - Pomona Women's Center

With a brand portfolio that includes Black Radiance, Lip Smacker, LORAC, Physicians Formula, and wet n wild, Markwins Beauty Brands' products are sold in retail outlets including department, specialty, mass, drug, and food stores, in over 80,000 doors in 80 countries worldwide. Develops new formulas for color cosmetics and skin care being responsible for the product conception through final shipping, including formula development, stability, package compatibility, and pilot batches.

Markwins Beauty Brands Asia Pacific Ltd

Sr. Manager, Research & Development (R&D)

You will be responsible for contributing to strategic direction and providing input into product and market development strategy and marketing plan strategies for assigned product(s), leading the development, planning, positioning, and launching activities, through to end of product life, for unique or complex Epson product(s), and forecasting and procuring products to meet inventory and business plan and financial goals. Oversees relationships with Marketing Communications, Documentation, Service/Support, Logistics, Seiko Epson Corporation, Inventory Planning, and other groups to manage the product throughout its lifecycle.

Epson America, Inc. is the U.S. affiliate of Japan-based Seiko Epson Corporation, a global technology company at the forefront of technological revolutions in imaging, robotics, precision machinery and electronics. Epson offers an extensive array of award-winning image capture and image output products for the consumer, photographic, business and graphic arts markets. The company is also a leading supplier of value-added point-of-sale (POS) printers and transaction terminals for the retail market. Founded in 1975, Epson America Inc. is headquartered in Long Beach, California.
By delivering on a strategy of Digital Image Innovation and a commitment to customer service and support, Epson America's executive management team continues to position the company as a leader, merging the world of still and moving images, supporting richer communications and bringing color to the lives of people all over the world.

Epson America Inc

Product Manager

When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. The Perioperative Nurse Manager possesses recognized leadership and sound Clinical skills and will actively assist the Administrative Director Perioperative Services, in coordinating business activities of Perioperative Services.

University of Southern California

Manager, Nursing - Surgery - Full Time 8 Hour Days (Exempt) (Non-Union) (Open)

They will collaborate with team members, overseas offices, First Party (1P) partners such as Microsoft, Nintendo, Sony, or Valve, and third-party (3P) partners to develop digital SKU plans and execute discount strategies based on industry best practices and internal policies. The company is known for creating many of the industry's beloved classic franchises such as PAC-MAN, GALAGA, TEKKEN, SOULCALIBUR, and ACE COMBAT, and publishing the critically acclaimed DARK SOULS series and the blockbuster title ELDEN RING.

BANDAI NAMCO Holdings Inc.

Associate Digital Sales Manager

Maintain a pulse on current and emerging patterns and trends in the video game industry, possessing deep knowledge of modern gaming, retailer insight, sales lifecycles, line planning, trends and play patterns, identifying new business opportunities. The company is known for creating many of the industry's beloved classic franchises such as PAC-MAN®, GALAGA®, TEKKEN®, SOULCALIBUR®, and ACE COMBAT®, and publishing the critically acclaimed DARK SOULS series and the blockbuster title ELDEN RING.

BANDAI NAMCO Entertainment

Licensing Manager

IRecruitee

D. in Psychology from an accredited institution· Active California license in good standing as an LCSW, LMFT, LPCC, or Licensed Psychologist· Minimum of two years of post-licensure clinical experience preferred· Minimum of five years of experience working in behavioral health, mental health, or related clinical settings· Experience providing clinical supervision, treatment planning, and case consultation· Direct clinical, case management, and group facilitation experience· Knowledge of evidence-based practices, rehabilitation principles, and behavioral health systems of care· Strong leadership, organizational, communication, and interpersonal skills· Intermediate computer proficiency and experience with electronic health records· Valid California driver's license, reliable transportation, and active automobile insurance. Preferred Qualifications · Experience working in Wraparound, Full Service Partnership (FSP), community mental health, or intensive outpatient programs· BBS-approved supervisor status or eligibility to provide clinical supervision· Experience with quality assurance, utilization review, and program development activities· Experience working with children, adolescents, and families· MAB Training and First Aid certification preferred· Familiarity with Short Doyle or similar behavioral health documentation systems preferred.

Clarvida

Clinical Manager LCSW LMFT

Bandai Namco Holdings Inc

You will build relationships with patients and their families, monitor patient progress, provide prescribed treatments, and educate caregivers to help ensure the best possible outcomes. Communicates with all physicians involved in the plan of care, other health care practitioners (as appropriate), and appropriate members of the interdisciplinary team related to the current plan of care and changes in the patient’s needs / condition.

Assisted Home Health & Hospice

RN Case Manager, Home Health (Full-Time Preferred)

FULL_TIME

HOUR

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Key Requirements and Technology Experience: 2+ years experience in Appeals, Grievances, Utilization Management, or Care Coordination in a health plan or TPA.

Pyramid, Inc

Appeals & Grievances Case Manager (California)

Leads strategic coding initiatives to improve net patient revenue, reduce denials, and enhance reimbursement across payer lines; Analyzes coding, documentation, and billing trends to identify revenue leakage and payer-specific risks; Develops and monitors coding performance metrics (e.g., accuracy, denial trends, documentation specificity) and reports outcomes to leadership; Partners with Finance, Revenue Cycle, and Clinical Leadership to align coding practices with organizational priorities; Drives improvements in documentation specificity to support reimbursement accuracy, risk adjustment, and quality reporting; Supports value-based care, risk adjustment, and quality initiatives impacting reimbursement and patient outcomes; Collaborates on payer audits, denials, and appeals to mitigate financial and compliance risk; Leads continuous improvement efforts through data analysis, workflow redesign, and system optimization; Operational & Compliance Oversight. QUALIFICATIONS: The successful candidate will possess experience and skills spanning a variety areas: Strong interpersonal and communication skills with the ability to collaborate across departments; Knowledge of coding regulations, documentation requirements, and payer guidelines; Ability to analyze complex information and translate it into actionable insights; Proficiency in EHR, practice management systems, and reporting tools; Coding Certification (COC, CPC, or CCS preferred); At least seven years of experience in coding, clinical documentation improvement, billing, or auditing; Experience in a community health center or similar healthcare environment; Preferred Strategic Competencies.

Open Door Community Health Centers

Coding Manager

Case management experience or equivalentMinimum of 1-2 years of clinical nursing experience preferred, with experience in chronic disease management, ambulatory care, case management, care coordination, population health, managed care, home health, or a related setting strongly preferred. The RN-Chronic Disease Case Manager works collaboratively with patients, families, healthcare providers, and interdisciplinary teams to promote chronic disease self-management, continuity of care, preventive health, and timely access to services.

Unicare Community Health Center, Inc.

Quality - Registered Nurse Chronic Disease Case Manager

In addition to treatment of severe substance use disorder, the residential program is able to serve the following specialty populations: pregnant and postpartum women, women with histories of trauma and/or domestic violence, women with co-occurring mental health disorders, women with history of traumatic brain injury, women with open DCFS cases, and women with criminal justice involvement. The Case Manager maintains a caseload and provides care by linking the client with appropriate services to address specific needs, such as: benefits, mental health, physical health, employment, probation, DCFS, housing, community resources, Outpatient Substance Use Disorder services, and Aftercare services.

Case Manager I, II, III

Coordinate communication and external service linkage including assisting with scheduling appointments, communicating with probation, scheduling child visits, communicating with DCFS, obtaining all court minute orders, providing appointment reminders for therapy and psychiatrist. HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

HealthRIGHT 360

Case Manager - Pomona Womens Center

The role drives five primary value drivers: membership growth and retention; STARS and quality; compliant RAF and revenue integrity; provider and hospital performance; and market profitability, including a medical loss ratio (MLR) target of 87% or less, subject to quality, access, and regulatory requirements. The Vice President / Orange County General Manager (VP/OC GM) serves as the senior local business leader responsible for development, execution, operational performance, and financial results of Alignment Health''s Medicare Advantage business in Orange County.

Alignment Healthcare Inc

VP, General Manager (OC)

The Team Manager is the leader of the Patient Care Team and that member of the team whose function is to: supervise, evaluate and coordinate the various component members of the interdisciplinary team; assure continuity of care from admission to discharge or transfer to bereavement; serve as patient advocate and coordinator for other social service and health care providers in the community who are involved in the care of the team's patients; assume responsibility for the maintenance of patient records from intake through discharge or transfer to bereavement. Assures that problems/grievances/service failures experienced by individual patients/families or physicians/MCOs are addressed with team members, vendors, other VITAS departments, and are resolved promptly and satisfactorily.

VITAS Healthcare®, a pioneer and leader in the hospice movement since 1978, is the nation’s largest provider of end-of-life care. Our name is derived from the Latin word for “lives” and symbolizes the VITAS mission: to preserve the quality of life for those who have a limited time to live.

 Headquartered in Miami, Florida, VITAS operates hospice programs in 15 states and the District of Columbia. VITAS has enjoyed dynamic growth since its founding as a volunteer organization by a United Methodist minister and an oncology nurse. Today, VITAS employs 11,773 professionals who care for terminally ill patients daily-primarily in the patients’ homes, and also in the company’s inpatient hospice units as well as in hospitals, nursing homes and assisted living communities/residential care facilities. VITAS team members include registered nurses, licensed practical nurses, home health aides, physicians, social workers, chaplains and other caregiving professionals.

VITAS Healthcare Corp

Team Manager Home Care

This position owns the daily, weekly, and monthly encounter data reconciliation lifecycles, manages staff performing sweeps and error resolution, tracks federal response files (999, 227CA, MAO-002), resolves clearinghouse rejections, and partners with internal teams to ensure valid HCCs successfully pass through all technical checkpoints. Key Responsibilities: Encounter Data Pipeline Oversight & Integrity: End-to-End Submission Management: Manage daily technical and operational data streams for all risk adjustment submissions, ensuring seamless transaction flows from internal claims systems through 837P/837I EDI layouts into RAPS and EDPS (or state Medicaid systems).

Publications Manager Jobs in Irvine, CA

Case Manager Astiva Health

Senior Manager, Business SOX IA Armanino McKenna Certified Public Accountants & Consultants

Media Relations Manager Neros Technologies

Case Manager - Pomona Women's Center Healthright 360

Sr. Manager, Research & Development (R&D) Markwins Beauty Brands Asia Pacific Ltd

Product Manager Epson America Inc

Manager, Nursing - Surgery - Full Time 8 Hour Days (Exempt) (Non-Union) (Open) University of Southern California

Associate Digital Sales Manager BANDAI NAMCO Holdings Inc.

Licensing Manager BANDAI NAMCO Entertainment

Clinical Manager LCSW LMFT Clarvida

Associate Digital Sales Manager Bandai Namco Holdings Inc

RN Case Manager, Home Health (Full-Time Preferred) Assisted Home Health & Hospice

Appeals & Grievances Case Manager (California) Pyramid, Inc

Coding Manager Open Door Community Health Centers

Quality - Registered Nurse Chronic Disease Case Manager Unicare Community Health Center, Inc.

Case Manager I, II, III Healthright 360

Case Manager - Pomona Womens Center HealthRIGHT 360

VP, General Manager (OC) Alignment Healthcare Inc

Team Manager Home Care VITAS Healthcare Corp

Manager, Risk Adjustment Encounter Data Reconciliation Inland Empire Health Plan

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