Job Title Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures
Job Description Leads and manages team responsible for special investigation unit (SIU) activities, specifically the prevention and detection of violation of applicable laws and regulations. Responsible to protect the business from liability of fraudulent or abusive
Job Title Manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health plans identify and track savings
Description Location: Long Beach, CA (Hybrid) Job Type: Full-Time Schedule: Hybrid schedule is 2 days in-clinic 8-hour shift Monday to Friday Day Shift We are looking for a compassionate person who loves an opportunity to make
Job Title Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record
Job Title Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective
