Caloptima jobs in Orange, CA

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CLAIMS QA ANALYST (15059-010915)
CalOptima 6 reviews - Orange, CA
The QA Analyst is responsible for auditing claims activity performed in the claims department following regulatory and internal guidelines in conjunction with
Sponsored by CareerBuilder - 15 days ago
CLAIMS RESOLUTION SPECIALIST (CUSTOMER SERVICE) (07777-11121...
CalOptima 6 reviews - Orange, CA
The Claims Resolution Specialist (CRS) is the first line of contact for CalOptima providers. The CRS will assist providers with questions related to the
Sponsored by CareerBuilder - 19 days ago
Medical Authorization Assistant - Case Mgmt (14303-012115)
CalOptima 6 reviews - Orange, CA
To assist the Case Management Department offering support services under the direction of the Director of Case Management, Manager of Case Management, Case
Sponsored by CareerBuilder - 23 hours ago

Manager, Audit & Oversight

CalOptima 6 reviews - Orange, CA
Leads the routine oversight, monitoring and auditing of all internal business functions within CalOptima, as well as externally delegated functions to ensure
4 days ago - save job - email - more...

Personal Care Coordinator

CalOptima 6 reviews - Orange, CA
This position will support the members in completing their health risk assessment (HRA) and development of an initial care plan. The Personal Care Coordinator
30+ days ago - save job - email - more...

QI Nurse Specialist (FSR Nurse Auditor)

CalOptima 6 reviews - Orange, CA
The FSR Nurse Auditor is responsible to audit the health network and CalOptima Direct provider offices based on prescribed State, Federal and CalOptima
5 days ago - save job - email - more...

Program Specialist (Translation & Interpreter Services)

CalOptima 6 reviews - Orange, CA
Under general supervision, this position supports CalOptima’s compliance with cultural and linguistic (C&L) State and Federal regulatory requirements. The
30+ days ago - save job - email - more...

Social Worker (Case Management)

CalOptima 6 reviews - Orange, CA
The Social Worker is a critical part of the case management team and acts as the primary contact for Social Services, California Childrens Services (CCS),
11 days ago - save job - email - more...

Sr. Claims Examiner

CalOptima 6 reviews - Orange, CA
The Senior Claims Examiner analyzes and processes claims. This position is responsible for following regulatory and internal guidelines in conjunction with
30+ days ago - save job - email - more...

Project Manager (QIP)

CalOptima 6 reviews - Orange, CA
This position is responsible for the development and implementation of short and long term programs that promote the quality of member care, improved member
30+ days ago - save job - email - more...

Medical Case Manager - Onsite Concurrent Review

CalOptima 6 reviews - Orange, CA
Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Direct members. The
30+ days ago - save job - email - more...

Health Coach

CalOptima 6 reviews - Orange, CA
The Health Coach assesses member needs and develops a disease management plan that meets member’s self-management needs and is aligned with the member’s
29 days ago - save job - email - more...

Training Program Coordinator

CalOptima 6 reviews - Orange, CA
Under general supervision, provides grievance & appeals specialized tasks relevant to an assigned program and/or projects. This position requires the ability
30+ days ago - save job - email - more...
Grievance Resolution Specialist (14160-14207-122914)
CalOptima 6 reviews - Orange, CA
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member
Sponsored by CareerBuilder - 22 days ago
Administrative Assistant (Long Term Care) (15118)
CalOptima 6 reviews - Orange, CA
The Administrative Assistant supports the Director, as well as the LTSS team and programs. Primary duties include preparing materials for committee meetings
Sponsored by CareerBuilder - 23 hours ago
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