We have an opportunity to join the Alliance as a Senior Payer Analytics Consultant in the Payment Strategy department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Payment Strategy Director, this position: Performs complex managed care payer financial modeling and analysis to evaluate the feasibility of payer reimbursement methodologies Conducts complex financial analysis to support successful payer reimbursement outcomes Coordinates and collaborates with internal and external stakeholders to achieve payer...
We have an opportunity to join the Alliance as the new Health Services Operations Manager in the Health Services Administration Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Health Services Officer, you will: Manage the Health Services Operations function, act as a subject matter expert, and provide guidance on Health Services departmental operations Manage the Health Services Division's regulatory reporting function Manage, lead, supervise, mentor, and train assigned staff...
We look forward to bringing on 10 Temporary Member Services Representatives to support a combination of high-volume member calls and walk ins. We are targeting 2 start dates: one at the end of December and another at the end of January. The initial training program is 3-4 weeks and rigorous; during this onboarding period attendance is required Monday - Friday, 8:00am to 5:00pm. This assignment is intended to go for...
We have an opportunity to join the Alliance as the Behavioral Health Program Manager in the Behavioral Health Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Behavioral Health Manager, this position: Manages day-to-day operational issues related to Behavioral Health (BH) activities and provides related clinical and operational guidance in alignment with Medi-Cal, Knox-Keene, and other regulatory and accreditation standards. Provides consultation as needed for health services departments regarding members...
Temporary Senior Complex Case Manager - Adult (RN) Location: Remote in California We have six Temporary positions available to join the Alliance as a Senior Complex Case Manager - Adult (RN) on the Care Management team Length of assignment will start as soon as possible and likely go through April 2025. WHAT YOU'LL BE RESPONSIBLE FOR Developing and managing an individualized comprehensive plan of care for members referred into the...
Temporary Registered Nurse (Remote in California) Location: Remote in California At Central California Alliance for Health, we offer an administrative healthcare setting for amazing nurses to bring their hands-on clinical experience into a health plan to have an impact in a number of different departments. Most of our temporary nurse positions are remote, offering flexibility to work from the comfort of your home or to join us in one of...
Temporary Claims Technician II Location: Remote in California We look forward to bringing on 10 Temporary Claims Technician IIs to support claims processing. We will start 5 Temporary employees in January. The training program is month-long and rigorous, and availability for the first month of the assignment is required Monday - Friday, 8:00am to 5:00pm. The length of the assignment is always dependent on business needs, and dates may change....
Temporary Senior Enhanced Care Management Advisor (RN) Location: Remote in California ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go from July 2024 to December 2024. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency...
Temporary Health Services Authorization Coordinator I Location: Remote in California ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go until the end of the year. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that...
Medicare STARS Program Manager Location: Remote in California We have an opportunity to join the Alliance as the Medicare STARS Program Manager in the Medicare Administration Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Medicare Program Executive Director, this position: Performs program planning and design in support of development and implementation of the Alliance's STARS Program and performs ongoing operational program management. Performs data analysis and reporting in support...
Provider Dispute Coordinator II Location: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California We have an opportunity to join the Alliance as a Provider Dispute Coordinator II in the Claims Quality Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Claims Quality Supervisor, this position: Coordinates and responds to moderate complexity level one inquiries in the Provider Dispute process Assists with...
Lead Payer Analytics Consultant Location: Remote in California We have an opportunity to join the Alliance as a Lead Payer Analytics Consultant in the Payment Strategy Department. This position can be filled remotely within the Pacific or Mountain Time Zones. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Payment Strategy Director, this position will: Functions as a strategic consultant to Alliance executive leadership in the areas of complex managed care...
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