Principal Planner Salary at Tustin Ca BETA

Job Description Company Overview:Our client is a leading healthcare located in Orange, CA, seeking a highly motivated and experienced program specialist coordinating the compliance with cultural and linguistic (C&L) state and federal regulatory requirements. Position Summary: The successful candidate must have at least 2 years of relevant experience in a healthcare setting and be bilingual. Work Duration: Up to 6 months Work type: On-site Position Responsibilities: •Coordinates incoming language translation and/or reviews requests of CalOptima Health member materials. •Interacts directly with members and providers to coordinate and book face-to-face interpreter requests with contracted interpreting vendors. •Coordinates the timely vending and completion of Alternative Format material, such as Braille, Audio and Large Print, with contracted vendors. •Coordinates the vending of professional translation and review services in one or more languages (Arabic, Chinese, Farsi, Korean, Spanish,

Overview: Founded in 1965, UC Irvine is a member of the prestigious Association of American Universities and is ranked among the nations top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UC Irvine has more than 36,000 students and offers 224 degree programs. Its located in one of the worlds safest and most economically vibrant communities and is Orange Countys second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. To learn more about UC Irvine, visit www.uci.edu. The UCI Center for Clinical Research was built on the belief that running clinical trials should be a seamless experience. We work across the UCI enterprise to offer patients, investigators, and industry partners the quick and effortless support they need to participate in and run successful clinical tr

Summary: Sr LOA-ADA Specialist The LOA/ADA Specialist will provide leave coordination services for associate leaves of absence under state and federal leave laws (including the federal Family & Medical Leave Act) and Company policy; and maintain, report on, and analyze leave related data. The LOA/ADA Specialist shall execute his/her duties with integrity and attention to confidentiality and accuracy. What we offer: Full-Time Benefits (Medical, Dental, Vision, Life) 401(k) with company match Training and Career Development Generous Paid Time-Off Responsibilities: Oversee administration by the Companys third-party leave administrator (TPA) of associate leaves of absence (under federal and state laws and Company policy, including but not limited to: FMLA, ADA, military, disability, Wellness, and workers compensation leaves) and coordinate with TPA as needed Perform leave administration activities to include but not limited to: preparing correspondence, data entry, management of return to

Job Description Job Description Job title - : Appeals and Grievance Specialist Location - Orange, CA - 92868 Max. Pay Rate - $25/hr. - 34/hr. on W2. Duration: 6 months (With possible extension) [MINIMUM 1 YEARS OF EXPERIENCE WITH APPEALS AND GRIEVANCE] Duties & Responsibilities: 95% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Maintains adequate information in CalOptima Health’s systems; ensures data collection, summarization, integration and reporting which includes case creation and management and events/activity tracking. Gathers pertinent information regarding the grievances and appeals received, including member or provider concerns, supporting information related to initial decision-making, new inform

Job Description Job Description Johnson Service Group (JSG) has immediate openings for Eligibility Specialists. This is a fully remote role- Must live on the West Coast. Bilingual Spanish - read, write and speak fluently Days/Hours: Monday-Friday 7:00am PST- 4:00pm PST Possible OT available on the weekend depending on workload Contract- 8+months $18.75 per hour Qualifications High School diploma or equivalent and three (3) to five (5) years of accounting/business experience with knowledge of generally accepted accounting procedures, analytical abilities, or equivalent combination of education and experience preferred. Intermediate knowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), California Continuation Benefits Replacement Act (Cal-COBRA) and Employee Retirement Income Security Act (ERISA) legislation. Strong experience with Micro

Training/Quality Control Specialist (Remote with up to 25% travel) About the Company: Universal Strategic Advisors LLC (US Advisors) is a small business consulting practice specializing in domestic and international government administration, technology implementation & application, law enforcement operations, homeland security solutions, immigration strategy and operations, border security, and compliance. US Advisors brings proven expertise and a trusted insider network to help our clients solve their toughest challenges while managing risk. We acknowledge that change is accelerating. None of us can afford to think just two steps ahead; every decision we make today impacts our ability to safeguard, evolve, grow, and thrive. Our practice is rooted in deep expertise leading organizations through transformation and building operational, analytical, and technological strategies to meet mission demands. Job Introduction: US Advisors is seeking a Training/Quality Control Specialist to desi

Job Description The HEDIS Specialist is responsible for the Coordination of P4P Self Reporting Audit, roadmap preparation, data collection and reporting processes in addition to HEDIS intervention activities to improve related clinical performance measures for the commercial and Medi-Cal lines of business. Additionally, this position will take a lead role in coordinating the efforts to improve and is responsible for coordination activities related to the HEDIS and IHA measures. Serves as the liaison with Network Management, Medical Management, IT and other ad hoc departments and programs as necessary. Responsibilities Coordinate completion of IHA and HEDIS roadmaps. Provide timely measure status reporting, including trending and analyzing of the data. Create ad-hoc reports to assist with the tracking of the P4P and HEDIS measures. Develop and respond to P4P and HEDIS Audit Corrective Action Plan (CAP) as necessary.|Develop and maintain the P4P and HEDIS training manual and documentatio

Job Description At Sunshine Enterprise USA, we're not just a company; we're a community of dedicated professionals committed to excellence and innovation. As a leading force in the business landscape, we take pride in bringing together great people and great organizations by fostering a work environment that values creativity, diversity, and growth. If you're ready to embark on a rewarding career journey with a company that prioritizes its employees, explore our current job opportunities below. Job Summary The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal and written Grievances and Appeals from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, and pharmacy and vision decisions. The incumbent has frequent external contact with members and families, healthcare providers, health networks, third-party administrators, and regulators.