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jobs at Caloptima

Medical Case Manager (Pre Authorization Nurse Reviewer) (15172-012716)

Caloptima - Orange, CA

This position, under the direction of the Manager of Prior Authorizations, is responsible for reviewing and processing requests for authorization and notification of medical ...

12 days ago, Sponsored by CareerBuilder

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Manager, Quality Analytics (HEDIS) (96248-012716)

Caloptima - Orange, CA

The HEDIS Manager works collaboratively with the Director to develop, implement, and evaluate health outcomes and performance measures pertinent to improvement in ...

12 days ago, Sponsored by CareerBuilder

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Health Educator

Caloptima - Orange, CA

Responsible for planning, implementing and evaluating health education activities for CalOptima members. Provides individual and group health education services and acts ...

7 days ago from Caloptima

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Program Assistant

Caloptima - Orange, CA

Under general supervision to provide assistance with specialized services relevant to an assigned program. Positions are normally assigned to particular program or project ...

NEW23 hours ago from Caloptima

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Health Coach

Caloptima - Orange, CA

The Health Coach assesses member needs and develops a disease management plan that meets member’s self-management needs and is aligned with the member’s ...

18 days ago from Caloptima

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Auditor (GARS)

Caloptima - Orange, CA

The Grievance and Appeals Auditor is responsible for auditing grievance and appeal activity performed within the GARS department to ensure that regulatory and internal ...

NEW23 hours ago from Caloptima

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Auditor (Non-Clinical)

Caloptima - Orange, CA

The Audit & Oversight Auditor will conduct routine oversight, monitoring and auditing of all internal business functions within CalOptima, as well as externally delegated ...

NEW23 hours ago from Caloptima

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Provider Network Specialist

Caloptima - Orange, CA

Functions as a liaison between CalOptima and contracted health networks/medical groups (collectively referred to as health networks) and facilitates effective ...

5 days ago from Caloptima

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Training Program Coordinator

Caloptima - Orange, CA

Under general supervision, provides grievance & appeals specialized tasks relevant to an assigned program and/or projects. This position requires the ability to design, ...

5 days ago from Caloptima

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Program Development Analyst, Sr.

Caloptima - Orange, CA

The Sr. Program Development Analyst provides project support to assist in the development and implementation of programs and initiatives, including: 1) research and ...

4 days ago from Caloptima

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