Overview. Under the direction of the Provider Payment Strategy Manager, this position will support thedevelopment, evaluation, and advancement of provider reimbursement methodologies to alignwith organizational strategies and objectives, including performance and alternative paymentapproaches, and advise executive-level leadership regarding the feasibility of various strategies.This position will require the utilization of a variety of methods, m...
Overview. Under the direction of the Provider Payment Strategy Manager, this position will support thedevelopment, evaluation, and advancement of provider reimbursement methodologies to alignwith organizational strategies and objectives, including performance and alternative paymentapproaches, and advise executive-level leadership regarding the feasibility of various strategies.This position will require the utilization of a variety of methods, m...
Overview. Under the direction of the Provider Payment Strategy Manager, this position will support thedevelopment, evaluation, and advancement of provider reimbursement methodologies to alignwith organizational strategies and objectives, including performance and alternative paymentapproaches, and advise executive-level leadership regarding the feasibility of various strategies.This position will require the utilization of a variety of methods, m...
Overview. To initiate and coordinate a multidisciplinary team approach to case management. Engages themember/member’s representative in a care plan that assists the member in meeting his/her healthand wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet thecomprehensive medical, behavioral, and psychosocial needs of the member, while promotingquality and cost-effective outcomes. Responsibilities. Provides c...
Overview. To provide administrative support to the department head, leadership team, and staff as assigned. Responsibilities. Fields telephone calls. Receives and directs visitors. Maintains assigned calendars and schedules. Schedules and coordinates meetings. Prints and distributes meeting packets. Creates and processes expense reports. Creates correspondence, forms, reports, graphs, visual presentations, and other related documents. Places cate...
Overview. The Supervisor of Provider Systems will supervise the day-to-day operations of the Provider Relations (PR) Department functions involving provider data used for operations, reporting and claims processing. Provides supervision, support and guidance to the PR Systems staff. Monitors inventory and disseminates work based on timeliness standards and competing priorities. Responsibilities. Supervises the daily functions of PR department Sys...
Overview. In collaboration with departmental and organizational leadership, supports the organization’s Population Needs Assessment activities through active and meaningful engagement in identified community workgroup and initiatives. On behalf of the health plan identifies and supports, key strategic activities and interventions that support alignment of collective agency efforts that promote and support efforts to encourage member health outcom...
Overview. The Epidemiologist will work with the Chief Medical Officer and collaboratively with HealthServices leaders and stakeholders to plan, design, implement, and analyze data for key projectsand initiatives. The Epidemiologist will monitor population health outcomes, providerecommendations for improvement, evaluate program practices, and contribute to evidence-baseddecision-making in support of Partnership’s mission. Responsibilities. ▪ Coll...
Overview. To be responsible for executing and managing diversity, equity, and inclusion (DEI) trainingprograms and initiatives to enhance the skills, knowledge and performance of the company,network provider, subcontractors, downstream subcontractors, etc. Participates in DEI trainingmeetings. Supports DEI Training all plan letter requirements set forth by DHCS. Supportsmonitoring of training completion of Partnership staff, network providers, su...
Overview. The Senior IT Project Manager is responsible for the successful delivery of large-scale, complex projects often involving multiple internal and external stakeholders through all phases of the SDLC. The Senior IT Project Manager helps set and follow clear project management standards including project plans, change controls, risk management, and other project management documents on given strategic initiatives. The Senior IT Project Mana...
Overview. Manages the administration of various Human Resources (HR) functions including employeerelations, performance management, employee development, process improvement, and otherdevelopment initiatives that support general HR administration. Works closely with HR uppermanagement to establish policies and implement procedures to accomplish the goals andobjectives of Partnership within budget and within applicable legal requirements. Responsi...
