Caloptima Jobs

Supervisor, Nursing Services (PACE)rnrnJob DescriptionrnrnDepartment(s): PACE (Program of All-Inclusive Care for Elderly)rnReports to: Manager, Clinic Operations, PACE CenterrnFLSA status: Non-ExemptrnSalary Grade: M - $85,000 - $121,000rnrnJob SummaryrnrnThe incumbent is responsible..

Clinical Auditor- Grievance and Appeals (GARS)rnrnJob DescriptionrnrnDepartment(s): Grievance & AppealsrnReports to: Manager, Clinical Operations - GARSrnFLSA status: Non-ExemptrnSalary Grade: L - $$77,000 - $109,000rnrnJob SummaryrnrnThe Grievance and Appeals (GARS) Auditor..

Member Liaison Specialist (No Bilingual)   Job Description Department(s): Member Liaison Program Reports to: Supervisor, Member Liaison Program FLSA status: Non-Exempt Salary Grade: C - $41,000 - $53,000 Job Summary..

Medical Case Manager (Ambulatory) - Whole Child ModelrnrnJob DescriptionrnrnDepartment(s): Case ManagementrnReports to: Supervisor, Case ManagementrnFLSA status: Non-ExemptrnSalary Grade: L - $77,000 - $109,000rnrnJob SummaryrnrnCase Management is an advanced specialty collaborative..

Member Liaison Specialist (Bilingual, Customer Service) (2 Openings)   Job Description Department(s): Member Liaison Program Reports to: Supervisor, Member Liaison Program FLSA status: Non-Exempt Salary Grade: C - $41,000 -..

Medical Case Manager (LVN) (Pre-Authorization Nurse Reviewer) (2 Openings)rnrnJob DescriptionrnrnDepartment(s): Utilization Management, Prior Authorization (PA)rnReports to: Supervisor, Utilization ManagementrnFLSA status: Non-ExemptrnSalary Grade: K - $70,000 - $98,000rnrnJob Summary:rnrnThis position is..

Member Liaison Specialist (Bilingual, Customer Service) (4 Openings)rnrnJob DescriptionrnrnDepartment(s): Member Liaison ProgramrnReports to: Supervisor, Member Liaison ProgramrnFLSA status: Non-ExemptrnSalary Grade: C - $41,000 - $53,000rnrnJob SummaryrnrnThis position will provide member..

Grievance & Appeals Nurse Specialist (2 Openings)rnrnJob DescriptionrnrnDepartment(s): Grievance and Appeals Resolution Services (GARS)rnReports to: Manager Clinic Operations, Grievance & AppealsrnFLSA status: Non-ExemptrnSalary Grade: M - $85,000 - $121,000rnrnThe Grievance..

Health Educator (Maternity Health) Job Description Department: Population Health Management Reports to: Manager, Population Health Management FLSA status: Non-Exempt Salary Grade: H - $59,000 - $77,000 Job Summary The Health..

Medical Case Manager (LVN) (Pre-Authorization Nurse Reviewer)rnrnJob DescriptionrnrnDepartment(s): Utilization Management, Prior Authorization (PA)rnReports to: Supervisor, Utilization ManagementrnFLSA status: Non-ExemptrnSalary Grade: K - $70,000 - $98,000rnrnJob Summary:rnrnThis position is responsible for..

Data Warehouse Reporting Analyst, Sr.rnrnJob DescriptionrnrnDepartment(s): Information Systems - Systems DevelopmentrnReports to: Supervisor, Systems DevelopmentrnFLSA status: Non-ExemptrnSalary Grade: N - $95,000 - $133,000rnrnJob SummaryrnrnThis position collaborates with the Information Services..

Health Educator (Maternity Health)rnrnJob DescriptionrnrnDepartment: Population Health ManagementrnReports to: Manager, Population Health ManagementrnFLSA status: Non-ExemptrnSalary Grade: H - $59,000 - $77,000rnrnJob SummaryrnrnThe Health Educator (Maternity Health) is responsible for engaging..

Technical Analyst, Int. (Records and Information)rnrnJob DescriptionrnrnDepartment(s): Information ServicesrnReports to: Sr. Manager, Information Services (Records and Information)rnFLSA status: Non-ExemptrnSalary Grade: J - $65,000 - $91,000rnrnJob SummaryrnrnThe Technical Analyst, Int. (Records..

Other opening in Orange, California. Clinical Auditor- Grievance and Appeals (GARS) Job Description Department(s): Grievance & Appeals Reports to: Manager, Clinical Operations - GARS FLSA status: Non-Exempt Salary Grade: L..

Manager, Case ManagementrnrnJob DescriptionrnrnThe position provides shared responsibility for the daily operations, activities and projects for the Case Management Department. This position will work under the general direction of the..

Manager, Information Services (Information Security)   Job Description Department(s): IS- Infrastructure and Operations Reports to: Director, Information Services (Infrastructure and Operations) FLSA status: Exempt Salary Grade: P - $117,000 -..

Supervisor, Case Management   Job Description Department(s): Case Management Reports to: Manager, Case Management FLSA status: Non-Exempt Salary Grade: M - $85,000 - $121,000 Job Summary This position will be..

QI Nurse Specialist (Departmental)rnrnJob DescriptionrnrnDepartment(s): Case ManagementrnReports to: Director, Case ManagementrnFLSA status: Non-ExemptrnSalary Grade: M - $85,000 - $121,000rnrnJob SummaryrnrnThe Quality Improvement (QI) Nurse Specialist-(Departmental) is responsible for overseeing regulatory..

Director, Fraud Waste & Abuse and PrivacyrnrnJob DescriptionrnrnDepartment(s): Office of CompliancernReports to: Executive Director, CompliancernFLSA status: ExemptrnSalary Grade: R - $144,000 - $204,000rnrnJob SummaryrnrnThe Director's responsibility is to ensure that..

Manager, Utilization ManagementrnrnJob DescriptionrnrnDepartment(s): Utilization Management (Delegate Monitoring)rnReports to: Director, Utilization ManagementrnFLSA status: ExemptrnSalary Grade: P - $117,000 - $165,000rnrnJob SummaryrnrnThis position manages the work activities of the Utilization Management..

Department(s): Case ManagementReports to: Supervisor, Case ManagementFLSA status: Non-ExemptSalary Grade: L - $77,000 - $109,000rn rnJob SummaryrnCase Management is an advanced specialty collaborative practice, responsible for providing ongoing case management..

Medical Case Manager (LVN) (Concurrent Review)rnrnJob DescriptionrnrnDepartment(s): Utilization Management (Concurrent Review)rnReports to: Supervisor, Utilization Management (Concurrent Review)rnFLSA status: Non-ExemptrnSalary Grade: K - $70,000 - $98,000rnrnJob SummaryrnrnThis position provides case management..

Program Coordinator (Health Network Provider Relations)rnrnJob DescriptionrnrnDepartment(s): Health Network Provider RelationsrnReports to: Supervisor, Health Network Provider RelationsrnFLSA status: Non-ExemptrnSalary Grade: C - $41,000 - $53,000rnrnJob SummaryrnrnThe position will be responsible..