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Member Services Manager / Job Req 671415434
Alameda Alliance
-
Alameda, CA
Under general guidance of the Senior Director, Member Services , and working in cooperation with other departments, Manager, Member Services is responsible for the oversight of the Member Services Representatives (Level III), MS Outbound Unit and Consultant Supervisor and operations of the Member Services Department. The Manager is knowledgeable of and responsible for com
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Posted 1 day ago
Member Services Supervisor / Job Req 671415436
Alameda Alliance
-
Alameda, CA
Under general direction from the Sr. Director, Member Services, the Member Services Supervisor is responsible for the day to day supervision of Member Services Representatives, collaborating with other department Supervisors and other department leadership members to meet and exceed performance targets. The Member Service Supervisor will primarily oversee Member Services
Email Job
Posted 1 day ago
Quality Improvement Project Specialist II / Job Req 688155083
Alameda Alliance
-
Alameda, CA
The Quality Improvement (QI) Project Specialist II is responsible for developing and implementing quality assessment and performance improvement activities that includes facilitation, quality monitoring, and evaluation of improvement projects. The QI Project Specialist II, as directed by Quality Improvement (QI) leadership, facilitates Quality Improvement Health Equity (Q
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Posted 1 day ago
Claims Specialist Supervisor / Job Req 688155089
Alameda Alliance
-
Alameda, CA
Under general direction from the Manager, Claims Operations Support, the Supervisor, Claims Specialist is responsible for the day to day supervision of Claims Specialist roles, collaborating with other department Supervisors and other department leadership members, in order to meet and exceed performance targets. Specialist staff activities include, but are not limited to
Email Job
Posted 1 day ago
Communications Initiative Specialist / Job Req 688155095
Alameda Alliance
-
Alameda, CA
The Communications Initiative Specialist develops, manages, and implements communication strategies and tactics in support of departmental and organizational objectives and in compliance with all applicable state and federal regulatory requirements, Alliance policies and procedures, and business requirements. Principal responsibilities include Manage programs, initiatives
Email Job
Posted 1 day ago
Director, Compliance & Special Investigations / Job Req 688155081
Alameda Alliance
-
Alameda, CA
Under the direction of the Chief Compliance & Privacy Office (CCO/CPO), this position leads the implementation and operations of the Health Plan's Compliance Program, including the HIPAA/Privacy and Anti Fraud programs, in accordance with the Department of Managed Health Care (DMHC) and Department of Health Care Service (DHCS) laws and regulations. This position works clo
Email Job
Posted 2 days ago
Executive Assistant / Job Req 688155082
Alameda Alliance
-
Alameda, CA
Under the direction and general supervision of the Chief Compliance & Privacy Officer (CCO/CPO), the Executive Assistant to the CCO/CPO performs a variety of complex, confidential, secretarial and administrative duties requiring a thorough knowledge of organizational procedures and precedents. The Executive Assistant to the CCO/CPO performs routine clerical, administrativ
Email Job
Posted 2 days ago
Provider Relations Representative III / Job Req 671415430
Alameda Alliance
-
Alameda, CA
Under general guidance from the Provider Services Manager, the Provider Relations Representative III is responsible for building long term relationships with physicians, physician groups, ancillary and behavioral health providers and their staff in a positive and proactive manner in order to support their understanding and compliance with Alliance contracts, policies, and
Email Job
Posted 6 days ago
Provider Dispute Resolution Analyst / Job Req 654633420
Alameda Alliance
-
Alameda, CA
Under the general direction of the Supervisor, Provider Dispute Resolution Supervisor the Provider Dispute Resolution (PDR) Analyst will review, research, and resolve complex and involved provider disputes for contracted as well as non contracted providers in accordance with state and federal guidelines. Conduct all pertinent research in order to evaluate, respond and clo
Email Job
Posted 7 days ago
Long Term Services and Supports (LTSS) Liaison / Job Req 688155092
Alameda Alliance
-
Alameda, CA
Under guidance from the Senior Director of Behavioral Health Services and LTC Operations, the LTSS Liaison is responsible for building long term relationships with all long term care facilities and homes in a positive and proactive manner. Principle responsibilities include Serve as a single point of contact for the LTSS Provider community in both a Provider representativ
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Posted 7 days ago
Member Services Representative I / Job Req 688155094
Alameda Alliance
-
Alameda, CA
Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a timely manner. Respond to all communications co
Email Job
Posted 7 days ago
Director Health Equity / Job Req 688155096
Alameda Alliance
-
Alameda, CA
This position is responsible for directly assisting the Chief Health Equity Officer (CHEO) in developing, implementing, analyzing, and refining the Alameda Alliance for Health's (AAH) goals and objectives related to healthcare equity (HCE), diversity, equity, inclusion and belonging (DEIB). The Director of Health Equity will partner with the CHEO and other leaders to stre
Email Job
Posted 7 days ago
Claims Processor II / Job Req 654607627
Alameda Alliance
-
Alameda, CA
Under the direct supervision of the Claims Processing Supervisor and the general direction of the Manager, Claims Production, this position is responsible for the accurate review, entry and processing of all claims received for payment by AAH. Principal responsibilities include Research claims for completion and appropriateness. Review and handle rejected claims as necess
Email Job
Posted 12 days ago
Outpatient Utilization Management Coordinator / Job Req 654610516
Alameda Alliance
-
Alameda, CA
The Utilization Management (UM) Coordinator will support clinical staff through completion of the administrative and nonclinical coordinator functional components of Utilization Management The Coordinator is responsible for continuous processing and monitoring of the review and authorization process and ensuring the quality, timeliness and accuracy for corresponding docum
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Posted 14 days ago
Medical Director Long Term Supportive Services / Job Req 637860952
Alameda Alliance
-
Alameda, CA
The Medical Director of LTSS is a member of the Medical Management Department of the Alameda Alliance for Health ("health plan") and assists the Chief Medical Officer in developing and implementing clinical policy designed to meet the DHCS triple aim improving the patient experience of care; improving the health of populations; and reducing the per capita cost of health c
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Posted 14 days ago
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