Director of Managed Care Operations (Hybrid)

Direct Hire + Hybrid! 100% Employer Paid Benefits! Professional Development/Tuition Reimbursement, look no further for your Director of Managed Care Operations Opportunity!

Job Title: Director of Managed Care Operations (Hybrid)
Location: Palm Desert, CA
Employment Type: Direct Hire
Schedule: Monday–Friday, 8AM–5PM
Pay: $150,000/year (flexible)

What you’ll do:

• Provide strategic leadership over Claims, Billing, Eligibility, Benefits, Materials Management, Business Informatics, and Contracting
• Drive accountability, controls, governance, and performance management
• Partner with the CFO/executive leadership on financial efficiency strategy and operational excellence
• Lead executive-ready reporting and communications (including monthly timeliness reporting)
• Oversee systems supporting operational/EDI needs (EMR, scheduling, reporting tools)

Required Qualifications for Director of Managed Care Operations:

• Bachelor’s Degree
• 10+ years of claims management experience (hands-on medical finance/claims required)
• 2+ years of people Leadership/Supervisory experience
• Knowledge of Medicare and DMHC regulations and managed care rules
• Familiarity with medical terminology and coding (ICD-9, CPT, RVS)

100% Paid Benefits:

• Medical insurance at no cost to employee (employer covered)
• No-cost pharmacy benefit (employee)
• Dental, Vision, EAP, Life/AD&D, LTD options
• 401(k) with company match; PTO (released after 90-day evaluation)

Referral Bonus (MediQuest):
Referrals really pay off. Do you know someone in healthcare looking for work? Refer them to MediQuest and earn up to $500 per referral, depending on the type of position they accept.

• No limit to the number of referrals you provide or the amount you can earn
• Anyone can earn a referral bonus - not just MediQuest candidates

About MediQuest:
MediQuest matches high-quality healthcare professionals with talented medical support staff. Our dedicated medical focus and expertise allow us to build collaborative partnerships with both clients and candidates, ultimately creating lasting value and delivering performance-based results in the constantly evolving healthcare industry. We have been connecting candidates with private practices, outpatient clinics, hospitals, independent physicians’ associations, medical billing services, urgent care, and healthcare administration since 1965. We know that it takes great people to make a great company.
PandoLogic. Keywords: Managed Care Director, Location: Palm Desert, CA - 92261