Primary Purpose. The HR Generalist plays a pivotal role in the human resources department, responsible for a wide range of HR activities to support the organization’s objectives and foster a positive workplace environment. This role involves handling various aspects of HR functions, including payroll, recruitment, employee relations, performance management, training and development, compliance, and HR Administration. Principal Duties and Responsi...
Primary Purpose. Provide support to the risk and quality team, IPA Administrators, VP of Clinical Services on Clinical Initiatives to improve patient outcomes and group quality measures in Risk Adjustment, CMS 5 Star as well as the commercial and MediCal programs. Principal Duties and Responsibilities (* = essential functions). Outreach and coordinate care for IPA members who are in need of preventative and/or chronic care services such as mammog...
Claims Business Analyst. Department. Claims. Effective Date. October 12, 2023. Reports to. Claims Director. Direct Reports. None. FLSA. Non-Exempt. Working Conditions. Remote, occasional travel to office, Normal, no adverse or hazardous conditions. Primary Purpose. Perform business analyst duties such as: evaluating existing process for process improvement and/or. department stabilization activities, frequent desk side walk-thru, process document...
Claims Data Entry and Mail Coordinator. Department. Claims. Effective Date. December 1, 2019. Reports to. Claims Manager. Direct Reports. None. FLSA. Non-Exempt. Working Conditions. Normal, no adverse or hazardous conditions. \\pdt1fp01\folder redirection$\dhall\Desktop\Claims Data Entry and Mail Coordinator 2019.doc. Primary Purpose. To process the medical claims of the company’s IPA clients pursuant to designated production quotes. for accuracy...
Position Justification. Check Cashing, COB Processing, Provider Dispute Redesign, VE Redesign, Denial. Letter Process Redesign, CVPG Remediation, Outbound Mail Streamlining, Policy and Procedures Road. Map, Training Plan Design, Automation Opportunities, Financial Quality Opportunities. Requirements. Gather business requirements of multiple project initiatives, including new business, change. management, work flow techniques, and remediation oppo...
Claims Quality Auditor. Department. Claims. Effective Date. July 20, 2023. Reports to. Claims Adjudication Supervisor. Direct Reports. None. FLSA. Non-exempt. Working Conditions. Normal, no adverse or hazardous conditions. Our established Medical Management Company is built on more than 100 years of collective. experience in the managed care (healthcare) industry. We specialize in managing. independent groups of physicians with commercial, MediCa...
