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Jobs in Fleming, GA

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Quality Improvement Specialist , Risk Adjustment, Covered California CalOptima

Orange, CA

$68,015–$108,824 / year

We are hoping you will join us as a Quality Improvement Specialist, Risk Adjustment, Covered California and help shape the future of healthcare where you'll be an integral part of our Quality Analytics team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Bachelor's degree in health care, health care data informatics or a related field PLUS 2 years of risk adjustment or quality improvement working experience in a health plan or medical group required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

14 days ago

Medical Billing Customer Representative University of California

Los Angeles, CA

$30.79–$40.60 / hour

Qualifications We're seeking detail-oriented, self-directed professional with: REQUIRED - Two years recent professionalbilling collection experience as well as two years of customer service experience. Two years recent professionalbilling collection experience as well as two years of customer service experience.

15 days ago

Senior Clinical Research Associate -Oncology Systimmune

Los Angeles, CA

$110,000–$145,000 / year

Prepare the study reference manual, including liaising with the Contract Research Organization (CRO) team (i.e., central lab, specialty labs and vendors) to ensure efficient preparation and delivery of study materials to investigator sites. CRA is responsible for the management and oversight of their assigned clinical study sites to ensure data quality and patient safety in accordance with ICH-GCP guidelines, local regulations, and applicable SOPs.

8 days ago

Physician Assistant or Nurse Practitioner Concentra

Irwindale, California

$155,000–$185,000 / year

Monitors key clinical center metrics that are provided by Clinical Analytics and relate to quality outcomes: Practice Indicators, COP, GRV, LOS, TAT, Specialist Referral Rate, Primary Care Case Duration, Days to First Recheck, % of cases with Lost Time, Limited Duty, and Full Duty. This position is eligible to earn a base compensation rate in the range of $155,000.00 - $185,000.00 plus Shift tipend , base salary depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority.

21 days ago

Supervisor - Claims Delegation Oversight Astrana Health, Inc.

Monterey Park, California

$78,000–$91,000 / year

Collaboration Build and maintain productive & collaborative intradepartmental relationships with department leads (UM, CM, Pharmacy, Eligibility, Performance Programs, Accounting/ Finance, Recovery, Compliance, Configuration, Network Management, IT Ops, etc.) to enable effective and timely problem/improvement identification & resolution and drive operational excellence. External Audit planning, execution & support Develop and implement the operational strategy for driving all external audits for Astrana Health to ensure audit planning and readiness, successful audit execution and delivery, CAP management, and improve overall audit score.

17 days ago

Physical Therapist Center Therapy Director Concentra Inc.

Chatsworth, CA

$95,000–$130,000 / year

This position is eligible to earn a base compensation rate in the state range of $95,000 to $130,000 annual salary depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority. Masters use of clinical systems to ensure efficient and excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders.

30+ days ago

Clinical Research Associate II - Oncology Systimmune

Los Angeles, CA

$90,000–$115,000 / year

Prepare the study reference manual, including liaising with the Contract Research Organization (CRO) team (i.e., central lab, specialty labs and vendors) to ensure efficient preparation and delivery of study materials to investigator sites. The CRA II is responsible for the management and oversight of their assigned clinical study sites to ensure data quality and patient safety in accordance with ICH-GCP guidelines, local regulations, and applicable SOPs.

7 days ago

Physical Therapist Center Director Concentra

Irwindale, California

$90,000–$120,000 / year

This position is eligible to earn a base compensation rate in the state range of $90k to $120k annual salary depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority. Masters use of clinical systems to ensure efficient and excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders.

16 days ago

Implementation Auditor (50487) Western Growers

Irvine, CA

Using close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.

30+ days ago

CDS Trainee Prime Healthcare Services Inc

Lynwood, CA

$26.04–$28.75 / hour

CDS Trainee is responsible for conducting clinically based concurrent and retrospective reviews of inpatient medical records to evaluate the clinical documentation is reflective of quality-of-care outcomes and reimbursement compliance for acute care services provided. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

3 days ago

Surgery Scheduler The Los Angeles Cancer Network

Glendale, California

$21–$28 / hour

Scheduler provides accurate information so that all departments may view daily and maintains open communication with hospital departments and physician offices regarding schedule changes. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

30+ days ago

Plan Coder (50456) Western Growers Association

Irvine, CA

This position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively.

30+ days ago

Implementation Auditor (50487) Western Growers Association

Irvine, CA

30+ days ago

Data Integrity Advocate I Claritev Corp

Manage multiple providers and locations within a single call, meticulously processing 20-40 data points per provider and location with precision, utilizing outbound dialer systems or comprehensive Excel spreadsheets. Initiate outbound calls to primarily contracted network providers, navigating intricate complexities to uphold the integrity of their demographic records and network standings.

1 day ago

Sr. Systems Controls Engineer PEAK Technical Services Inc.

Monrovia, CA

$110,000–$140,000 / year
Quick Apply

Pre-sale conceptual design, schedule, and cost estimation of control architecture for semi-automated and fully automated industrial processing workstations. • Structured, re-useable low-level motion control system code for Delta-Tau, Aerotech, and Client motion systems implementing control system and I/O functions.

30+ days ago

RCM Supervisor OneOncology Inc

Remote

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

14 days ago

Specialty Physician Coder Iconma LLC

Fountain Valley, CA

This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.

30+ days ago

RN or NP Clinical Documentation Integrity Specialist, Hybrid myPlace Health

Los Angeles, California

$71,700–$105,000 / year

Operating within the PACE model, the CDI Specialist conducts clinically supported chart reviews, identifies documentation opportunities, and collaborates with physicians, nurse practitioners, and care teams to support compliant CMS-HCC capture and sustainable documentation improvement. This clinically credentialed role partners with providers, interdisciplinary care teams, and risk adjustment stakeholders to ensure documentation reflects each participant’s clinical complexity, disease burden, severity of illness, and care needs.

16 days ago

Utilization Management Assistant - Utilization Management Providence Health & Services

Mission Hills, CA

$24–$31.52 / hour

Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care.

30+ days ago

Patient Care Service Representative Modena Allergy + Asthma

Huntington Beach, California

Modena Health (“MH”) and Modena Allergy & Asthma ("MAA") are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona—and ambitious plans for national expansion. Our model combines hospitality-driven service with innovative technology solutions that streamline operations, improve clinical outcomes, and enhance the experience for both patients and providers.

2 days ago

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Jobs in Fleming, GA

Quality Improvement Specialist , Risk Adjustment, Covered California CalOptima

Medical Billing Customer Representative University of California

Senior Clinical Research Associate -Oncology Systimmune

Physician Assistant or Nurse Practitioner Concentra

Supervisor - Claims Delegation Oversight Astrana Health, Inc.

Physical Therapist Center Therapy Director Concentra Inc.

Clinical Research Associate II - Oncology Systimmune

Physical Therapist Center Director Concentra

Implementation Auditor (50487) Western Growers

CDS Trainee Prime Healthcare Services Inc

Surgery Scheduler The Los Angeles Cancer Network

Plan Coder (50456) Western Growers Association

Implementation Auditor (50487) Western Growers Association

Data Integrity Advocate I Claritev Corp

Sr. Systems Controls Engineer PEAK Technical Services Inc.

RCM Supervisor OneOncology Inc

Specialty Physician Coder Iconma LLC

RN or NP Clinical Documentation Integrity Specialist, Hybrid myPlace Health

Utilization Management Assistant - Utilization Management Providence Health & Services

Patient Care Service Representative Modena Allergy + Asthma

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