, this position will help to plan, organize, and implement Alliance Behavioral Health program. The BH Navigator will support clinical... complex patients with mental health disease to access care. Works with licensed staff to ensure best practices...
will help to plan, organize, and implement Alliance Behavioral Health program. The BH Navigator will support clinical staff... process and corresponding documentation. Under the general direction of the Behavioral Health Supervisor, this position...
objectives, and assuring that Alameda Alliance goals are met. Principal responsibilities include: Interact with all departments... administration of claims.Meet regularly with other Local Health Plans of California (LHPC) Claims Directors/Managers to discuss...
is operationalized to achieve business, operations, and reporting objectives, and assuring that Alameda Alliance goals.... Provide leadership to the Claims management team in alignment with the Alliance's core values, building a high performing team...
to offer a comprehensive scope of services to both job applicants and Alameda Alliance for Health (AAH) leadership for recruiting... and other reports for the Alameda Alliance recruiting team. (5%) Monitor and manage engagement of temporary staff and consultants...
by Credentialing staff to ensure they meet the requirements of Alameda Alliance for Health's (Alliance) regulatory agencies... and/or guidelines (i.e., California Code of Regulations Title 22, NCQA, DHCS, DMHC, and CMS) and the Alliance's credentialing policies...
and processing of claims received for payment by Alameda Alliance for Health (AAH). Principal responsibilities include: Research... Office software (Outlook, Word, Excel) Salary Range $27.11 - $40.66 Hourly The Alliance is an equal opportunity employer...
a team dedicated to Medicare compliance monitoring, auditing, and risk mitigation at the Alameda Alliance for Health... OR TRAINING EQUIVALENT TO: Bachelor's degree required in business, healthcare administration, public health, law, or related...
as developed for the department, towards the successful delivery of Alameda Alliance for Health (AAH) assignments. This role... with a health-plan or similar organization. Master's degree a plus MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE: 2+ years...
in areas of health care related applications, authorizations, and enrollment file management, under the supervision of the... configurations and excellent hands-on experience to manage changes/features and processes to various health care related applications...
of the Alliance, transforming data into insights to drive business values. This position requires an in-depth understanding... in a business, health related, finance, technical or other related field of study or equivalent professional experience MINIMUM...
the analytic needs of the Alliance, transforming data into insights to drive business values. This position requires..., health related, finance, technical or other related field of study or equivalent professional experience MINIMUM YEARS...
updates, health status, as well as identify, manage, and escalate risks to mitigate impacts Ensure benefits realization...'s degree in business, health care, or a related field and a minimum of four years of process improvement experience...
Alliance Medical Director to validate patient acuity and plan of care; Extrapolate and summarizes medical information... and refer member to the Case and Disease Management department, and the Health Homes Program as necessary. Identify patients...
standards/guidelines to determine medical necessity for the service being requested. LTC: Providing health plan clinical... and efficiently for the Alliance members. Utilizes assessments, member-centered care planning, direct provider coordination...
for designing, developing, and delivering comprehensive trainings for the Alliance's Medicare Advantage Dual Eligible Special Needs... as a subject matter expert (SME) in training for the Alliance and Medicare Advantage D-SNP product that is consistent with the...
Coordinator is responsible for coordinating, monitoring and maintaining the credentialing and recredentialing processes of health... care providers and practitioners to ensure they meet the requirements of the Alliance credentialing policies and regulatory...
guidelines, and collaborating with other departments to ensure the Alliance's business, operating, and reporting goals..., as needed. Provide advice to other Alliance departments on claims related issues by phone, email or in person. Prepare, review...
RANGE: $34.80 - $52.21 HOURLY The Alliance is an equal opportunity employer and makes all employment decisions on the basis of merit and business... necessity. We strive to have the best-qualified person in every job. The Alliance prohibits unlawful discrimination...
. SALARY RANGE: $142,043.20 - $213,075.20 Annually The Alliance is an equal opportunity employer and makes all employment... decisions on the basis of merit and business necessity. We strive to have the best-qualified person in every job. The Alliance...