SummaryResponsible for successful execution, coordination and support of PacificSource’s clinical/quality improvement initiatives, across all lines of business. Key areas of focus include oversight and management of provider clinical engagement and performan…

JOB SUMMARY: Is responsible for adjudicating complex claims which include high dollar claims. Responsible for accurate manual/auto pricing of claims. Identify provider billing issues that impact claims processing. Works closely with the Supervisor to identify …

JOB SUMMARY: Support the Utilization Management (UM )Program and required regulatory deliverables for Imperial Health Plan of California, Inc. / Imperial Health Holdings Medical Group. May support the NCQA Accreditation Program and oversight processes, accredi…

Why Choose Jefferson Health Plans?We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of ou…

People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a s…

Motion Picture Industry Pension & Health Plans (MPI) has a key opportunity for an experienced and talented Human Resources Generalist with deep LOA experience, strong technical skills and performance management experience to join a growing organization and HR …

Job Summary The Product Solutions Manager III is responsible for assisting the product leadership team within the Product Strategy, Sales and Marketing (PSSM) service area and the enterprise. The Product Solutions Manager III leads in supporting ongoing op…

What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Business Relationship Manager (BRM) is responsible for …

Position Summary:We are hiring a clinical Nutritionist to join our Nutrition Department. As a Nutritionist, you will be responsible for providing education and counseling to high-risk patients and their families in our primary care and multi-specialty health c…

Urban Health Plan is a network of federally qualified community health centers that offers comprehensive, affordable, quality primary and specialty health care. We are located in the Bronx, Queens, and Manhattan and are accredited by the Joint Commission.At Ur…