Regal Medical Group in United States
87 jobs at Regal Medical Group in United States
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Sr. Director Risk Adjustment
5 days ago
Regal Medical Group California, United StatesThe Director of Risk Adjustment is responsible and accountable for the performance of a specific region in terms of RAF score for all product lines that risk adjust and quality scores for all product lines. The Director will be working with internal staff, larger and exclusive PC ...
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Outpatient Coordinator
1 day ago
Regal Medical Group Covina, United StatesJob Description · The Coordinator, Outpatient is responsible for coordinating non-clinical tasks to support the delivery of case to members who meet case management criteria. Responsibilities include but are not limited to assisting in scheduling medical appointments, durable me ...
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HTML Programmer
1 day ago
Regal Medical Group Northridge, United StatesJob Description · Position Summary: · The HTML Programmer has responsibility for design, testing, installation, training, upgrades, enhancements and ongoing support of all systems developed internally by Regal Medical group and other affiliates of Heritage Clinical Services. A w ...
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Outpatient Coordinator
1 week ago
Regal Medical Group Covina, United StatesJob Description · The Coordinator, Outpatient is responsible for coordinating non-clinical tasks to support the delivery of case to members who meet case management criteria. Responsibilities include but are not limited to assisting in scheduling medical appointments, durable me ...
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Network Coordinator
1 day ago
Regal Medical Group California, United StatesThe Coordinator, Network Management is responsible for working as the internal liaison in maintaining, processing and reviewing department databases and reporting on a daily basis to assist the Network Management Department in meeting the overall network growth and development go ...
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Social Worker
6 days ago
Regal Medical Group San Bernardino, United StatesJob Description · Position Summary: · Under the direction of Senior Manager, Social Services and collaborating closely with the Medi-Cal SPD Case Management Team, the Medi-Cal SPD Social Worker is responsible for assisting in the successful implementation of the newly launched M ...
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Patient Care Coordinator
2 days ago
Regal Medical Group West Covina, United StatesJob Description · Position Summary: · The Coordinator, Patient Care is responsible for coordinating non-clinical tasks to support the delivery of care coordination to patients. Responsibilities include but are not limited to assisting in scheduling medical appointments, durable ...
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Network Specialist, Provider Network
1 week ago
Regal Medical Group San Bernardino, United StatesNetwork Specialist, Provider Network #UHM-2916 · Area of Interest · Provider Network · Position Type · Full-time · Job Description · Position Summary: · The Specialist, Network Management is responsible for providing administrative support to the Executive assigned and is ...
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Benefits Coordinator
12 hours ago
Regal Medical Group Los Angeles, United StatesJob Description · Position Summary: · Provide efficient and accurate information to prior authorization requests. Ensure that correct benefits, co-pays and financial responsibility are provided to Prior Auth requestors. · Essential Duties and Responsibilities include the follo ...
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Project Manager CQM
1 week ago
Regal Medical Group Northridge, United StatesJob Description · Position Summary: · The Project Manager for Continuous Quality Monitoring Department (CQM), directly reports to Vice President of CQM. The role is responsible for leading regulatory audit projects. Set up internal monitoring projects to monitor the UM process, ...
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Human Resources Manager
1 week ago
Regal Medical Group Los Angeles, United StatesJob Description · Position Summary: · The Human Resources Manager provides guidance on the interpretation of HR policies, federal and state employment law compliance, with the ability to manage all facets of HR. Reporting to the Director of Human Resources, this position is in ...
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Nurse Practitioner, HCC Wellness
1 day ago
Regal Medical Group Northridge, United StatesJob Description · Position Summary: · Assumes responsibility and accountability for the nursing assessment and/or primary care for a selected population of senior patients. Provides annual wellness assessments for senior patients in variety of settings. Maintains currency of lic ...
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Business Systems Analyst
5 days ago
Regal Medical Group California, United StatesThe Business System Analyst position is responsible for designing and testing system enhancements, modifying workflows to improve production, and expanding systems to serve new purposes. This position formulates/defines systems scope and objectives based on user needs, prepares d ...
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Claims Auditor
12 hours ago
Regal Medical Group West Covina, United StatesJob Description · Position Summary: · This position is responsible for maintaining routine auditing functions and providing feedback on departmental activities, to assure compliance with all health plan and regulatory agencies, including CMS, DMHC, and DHS. This position includ ...
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HCC Auditor
4 days ago
Regal Medical Group Los Angeles, United StatesJob Description · Job DescriptionWe are looking for HCC Risk Adjustment Auditors/Coders to join our team · Position Summary: · The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This pos ...
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COB Specialist
5 days ago
Regal Medical Group California, United StatesThis position is directly responsible for researching and maintaining coordination of benefits of all contracted and non contracted health plan entities as reported by any health plan, provider, Medicare, TPL, Workers Comp or internal departments. They are to ensure that all EZ-C ...
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Behavioral Health Case Manager RN
6 days ago
Regal Medical Group California, United StatesArea of Interest · Utilization/Quality Management · Position Type · Full-time · Job Description · Position Summary: · The Behavioral Health Case Manager RN collaborates with an inter-disciplinary care team to provide patient-centered case management and support to members with pr ...
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Credentialing Coordinator
1 day ago
Regal Medical Group Northridge, United StatesJob Description · Position Summary: · Credential all new providers, Re-credential existing Providers according to Regal Medical Group credentialing policies and procedures. Submit credentialing information as requested by contracted HMOs. Maintain and update files on all credent ...
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Artificial Intelligence Analyst
5 days ago
Regal Medical Group California, United StatesArtificial Intelligence Analyst · #UHM-3020 · {{jcity}}{{jstate}} · IT · Position Type · Full-time · Job Description · Position Summary: · As an AI Analyst at Regal Medical Group you will play a pivotal role in leveraging artificial intelligence (AI) and machine learning (ML) te ...
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Nurse Practitioner
5 days ago
Regal Medical Group Los Angeles, United StatesJob Description · Job DescriptionPosition Summary: · Assumes responsibility and accountability for the nursing assessment and/or primary care for a selected population of senior patients. Provides annual wellness assessments for senior patients in variety of settings. Maintains c ...