Jobs
>
Los Angeles

    Manager of Claim Data Management - Los Angeles, United States - Pailin Group Psc

    Pailin Group Psc
    Pailin Group Psc Los Angeles, United States

    1 week ago

    Default job background
    Description
    Req No Category Managed Care Type Regular Full-Time
    The Manager of Claim/Provider Data Management is integral part of the organizations Managed Care Division's leadership team.

    He or she is responsible for projecting and integrating the Mission and Core Values of the organization in the provision of provider data management services to internal and external customers of the Managed Care Division.

    In addition to overseeing the day-to-day operations of the Provider Data Management Department, he or she is responsible for and directs the configuration of the organization's provider management system for the accurate and compliant adjudication of claims from the organization, Medicare and Medicaid health plans, Ryan White Care Act (RWCA) programs and wellness and prevention (sexually transmitted disease testing) programs.

    The Manager of Claim/Provider Data Management is responsible for management of the claims suspense/errors file.

    The Manager of Claim/Provider Data Management leads the PDM staff by connecting its daily activities to the mission and core values of the organization to deliver a positive experience to contracted and non-participating medical providers and provider groups and the Department of Medicine and Public Health Division.

    He or she develops and implements the organization's contracts and fee schedules that meet national claims adjudication standards and best practices and standards required by the Centers for Medicare and Medicaid Services (CMS), California Department of Health Care Services, Florida Agency for Health Care Administration, and state-issued standards where AHF operates a healthcare center or where the organization will operate a health plan in the future.

    He or she is responsible to oversee the claims pre-processing vendors.

    The Manager of Claim/Provider Data Management is responsible for implementing and adhering to Management Philosophy of mission driven, fairness, learning, hands-on, accountability and tenacity in the leadership of Claims Department.

    He or she contributes to the organization's success.

    TO APPLY
    Forward resumes and salary requirements to Debra Hartmann at

    #J-18808-Ljbffr
  • Chrysalis Center Inc

    Data & Grants Manager

    1 week ago

    Chrysalis Center Inc Los Angeles, United States

    **Job Summary**: · The Data and Grants Manager is responsible for the programmatic management of grants and contracts, tracking program performance and managing contract relationships. The Data and Grants Manager will play a key role in implementing grant agreements and associate ...

  • AmeriCorps

    24-25 Bgc of The Foothills Data Management Vista

    1 week ago

    AmeriCorps Los Angeles, United States

    Boys Girls Club of the Foothills (BGCF) was established in response to high levels of delinquency, juvenile crime, gang activity and drug use among youth in the densely populated, multi-ethnic areas of Monrovia and Duarte in Los Angeles County. Our mission is to enable all young ...

  • Longwood University

    Data Manager

    2 weeks ago

    Longwood University Los Angeles, United States

    You are viewing a preview of this job. Log in · or register · to view more details about this job. · Everytown for Gun Safety, the nation's largest gun violence prevention advocacy group, is seeking a Data Manager. We are looking for a skilled communicator, technologist, and st ...

  • MV Transportation

    Data Manager

    3 days ago

    MV Transportation Los Angeles, United States

    Job Description · Overview · If you reside in California, please see our California Applicant Privacy Policy for more information about our data handling practices and your data rights: · Responsibilities · MV Transportation is seeking aData Managerto ensure that all personnel ...

  • MV Transportation

    Data Manager

    2 weeks ago

    MV Transportation Los Angeles, United States

    Overview: · If you reside in California, please see our California Applicant Privacy Policy for more information about our data handling practices and your data rights: · Notice at Collection and Privacy Policy for California Job Applicants · California Privacy Rights Act Requ ...

  • CPO Commerce, LLC

    Data & Analytics Manager - Cpo

    4 days ago

    CPO Commerce, LLC Pasadena, United States

    **Scope**: Manages team of 3-5 Data Architects, Developers and Data Engineers · **Major Responsibilities**: · - Oversees the work of the data & analytics team, ensuring its accuracy. · - Takes the lead on developing processes for effective data analysis and reporting. · - Manages ...

  • Sloomoo Institute LLC

    Manager - Data Management

    2 weeks ago

    Sloomoo Institute LLC Los Angeles, CA, United States Full time

    We are an art-inspired, immersive haven of color, design and play. Launched in NYC in the fall of 2019, Sloomoo Institute has been an enormous success, attracting hundreds of thousands of guests and billions of media impressions. Even more, play is known to support stress relief ...

  • First American Financial Corporation

    Data Acquisition Manager

    1 week ago

    First American Financial Corporation Santa Ana, United States

    **Who We Are**: · **What We Do**: · Focused on the acquisition and processing of new source data and serve as the support between data sourcing and production. Data Acquisition Analysts are responsible for the daily communication with counties, vendors, offshore partners, and/or ...

  • Hybrid Promtions LLC

    Master Data Manager

    1 week ago

    Hybrid Promtions LLC Cypress, United States

    Hybrid's humble beginnings started in 1997 in the back of a print shop designing, selling, and printing tee shirts. Today, Hybrid is a global apparel industry powerhouse in brand and licensing management. Hybrid provides its expertise and fully vertical operations capability - de ...

  • ALS Network (formerly The ALS Association Golden West Chapter)

    Assistant, Data Management

    20 hours ago

    ALS Network (formerly The ALS Association Golden West Chapter) Woodland Hills, United States

    The Assistant, Data Management (ADM) will assist the Director, Data Management (DDM) on projects related to data acquisition and integration, as well as core operational and database methodologies. The ADM works with the DDM to ensure the database can be used to produce accurate, ...

  • L.A. Care Health Plan

    Manager, Encounter Data

    5 days ago

    L.A. Care Health Plan Los Angeles, United States

    Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in f ...

  • University of California

    Data Intelligence Manager

    4 days ago

    University of California Los Angeles, United States

    Take on an important leadership role in a world-class health organization. Drive innovative data processes that support exceptional patient care. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · Reporting to the Assistant Directo ...

  • Fitt Talent

    Data Analytics Manager

    3 days ago

    Fitt Talent Los Angeles, United States

    Fitt Talent Partners is a specialized recruitment firm working with top health, fitness, and wellness companies. · We're filling this role for a client - A fast-growing human performance company offering the highest quality supplements designed to enhance physical and cognitive ...

  • GOBankingRates

    Data QA Manager

    1 week ago

    GOBankingRates Los Angeles, United States

    GOBankingRatesTM is unique in the digital marketing and media industry - we combine marketing, digital, content and fintech. Our performance based approach increases brand awareness and generates targeted audience engagement on our internal web properties and partner sites. · Le ...

  • Better Talent Advisors

    Data Program Manager

    3 days ago

    Better Talent Advisors Los Angeles, United States

    SUMMARYHiring, training and mentoring of data team members · Oversees all product data in NetSuite & E-Commerce system including but not limited to: pricing, images, attributes, descriptions, categorizations. · Oversees all data gathering tasks, including but not limited:to con ...

  • SpreeAI Corporation

    Data Management Leader

    2 weeks ago

    SpreeAI Corporation Los Angeles, CA, United States

    SpreeAI is a fast-growing, innovative AI technology company with a core focus on revolutionizing the ecommerce and fashion landscapes. We thrive in a dynamic, fast-paced environment where creativity meets technology. Our mission is to revolutionize the fashion industry by creatin ...

  • University of California

    Data Intelligence Manager

    1 day ago

    University of California Los Angeles, United States

    Take on an important leadership role in a world-class health organization. Drive innovative data processes that support exceptional patient care. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · Reporting to the Assistant Director ...

  • City National Bank

    Data Management Lead

    2 weeks ago

    City National Bank Los Angeles, CA, United States

    DATA QUALITY LEAD · Position is responsible for the development of the Data Quality strategy, framework, operating model and the ongoing operations of the function and related activities. Establishes data accuracy steps by enrolling various stakeholders, data owners, data stewar ...

  • LA Promise Fund

    Data and Analytics Manager

    1 day ago

    LA Promise Fund Los Angeles, United States

    Job Description · Job DescriptionSalary: $66,560 - $70,000 · POSITION SUMMARYThe Data & Analytics Manager reports to the Director of Data & Analytics and is responsible for helping with the implementation of high-quality data collection and analysis practices across school sites, ...

  • Selby Jennings

    VP of Data Management

    2 weeks ago

    Selby Jennings Los Angeles, CA, United States

    Investment Banking Vice President will be responsible for: · Manage and create excel-based Beauty and Wellness forecast market models. · Perform multiple kinds of research using different inputs such as the news, industry-specific databases. · Help in the distillation of data ...