• US National

Perform in-depth analysis of large and complex healthcare datasets, generate actionable insights to support business objectives, develop and maintain dashboards and reports to communicate findings to stakeholders, utilize advanced SQL skills and Pyth..

• US National

Own the end-to-end solution for enterprise EDI & Dashboarding & Reporting teams. Develop domain knowledge in value-based care operations. Align solutions with senior leadership. Partner with data engineers, scientists, and analysts to design enterpri..

• US National

We are seeking an experienced and detail-oriented Data Operations Manager to oversee our data operations team. The ideal candidate will possess strong management skills, expertise in operational report building, and advanced proficiency in SQL...

• US National

Provide analytical support to internal and external stakeholders for claims and operational data. Convert complex data into meaningful insights using SQL and data visualization tools. Collaborate with fellow Data Analysts on best practices for data a..

• US National

Lead, coordinate, and manage technical projects throughout entire software development life cycle. Define projects and business needs, collect requirements, and create project documentation. Collaborate with stakeholders and hold team accountable for..

• Monterey Park, CA

Develop and implement strategies for optimizing healthcare resource utilization. Create and enforce UM policies and procedures. Provide leadership and supervision to utilization review department. Manage a team of UM staff.

• Monterey Park, CA

Comply with policies and procedures for processing deferrals and denials, review and process assigned deferrals or denials with accuracy and quality, monitor denial inquiries and respond to provider emails, maintain patient privacy and confidentiality.

• Alhambra, CA

Develop and implement patient experience improvement initiatives, analyze member experience data, track metrics, and collaborate with teams to identify areas for improvement. Liaise between Medical Groups and stakeholders to address member experience..

• Alhambra, CA

Manage day-to-day accounting operations, ensure accurate financial reporting and compliance with accounting standards. Direct management and development of a team of accountants, review IBNR and perform related analysis, and assist in preparation of ..

• US National

Answer daily calls, collect information, verify claims, and provide quality service to customers. Assist with member outreach, appointment scheduling, and resolution of concerns. Bilingual in Mandarin/Cantonese required.

• Monterey Park, CA

Responsible for conducting comprehensive reviews of clinical documentation, clinical criteria/guidelines, and policies to manage deferrals and denials. Comply with company policies and process assigned deferrals or denials with accuracy and quality.

• CA

Coordinate office activities, collect and summarize meeting minutes, prepare reports, and communicate with internal and external contacts. Understand HIPAA principles and maintain confidentiality. Must be able to travel.

• Monterey Park, CA

Responsible in notifying the bed control such as AHMC Central Command Bed Control & others, via telephone call or through a secure messaging system for possible transfer once accepted by ASTH IPA Hospitalist

• Monterey Park, CA

Process Routine & Urgent treatment authorization requests according to the NMM Policy & Procedure Manual based on UM Level 1 review process. Assist with attaching incoming notes to appropriate authorizations.

• Los Angeles, CA

Manage and coordinate logistics for meetings, events, and travel for executives. Compile reports and presentations. Prioritize and lead activities for executives. Respond effectively to inbound calls and emails.

• Alhambra, CA

Plan and perform operational and compliance audits of information systems and applications. Evaluate internal control structures and assess compliance with policies, procedures, regulations, and management objectives. Develop and document audit issue..