Top 697 Care director Jobs in Fairfield, Ca

Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Area Manager, Primary and Urgent Care Clinics
Northbay Healthcare —Vacaville, CA
- $150,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
- 403(b) matching
- Health insurance
Associate Director of Utilization Management
Partnership HealthPlan of California —Fairfield, CA
- $162,227.25 - $210,895.42 a year
- Full-time
- Nursing
- RN License
- Word processing
1d
Medical Director - Hospice on-site Full time
VITAS Healthcare —Fairfield, CA
- $280,000 - $320,000 a year
- Full-time
- Medicine
- Inpatient
- Home Health
- Disability insurance
- Health insurance
Quick Apply
Associate Veterinarian
Petco —Fairfield, CA
- $95,600 - $203,000 a year
- Full-time
- Fair chance
- Computer skills
- In-person
- Health insurance
- 401(k)
Occupational Therapist (OT) – Home Health | East Bay Territories (FT & Per Diem) - $10,000 Sign on Bonus (FT)
Health Link —Walnut Creek, CA
- $125,000 - $146,000 a year
- Part-time
- Mid-level
- Driver's License
- Home Health
- Health insurance
- Dental insurance
Quick Apply
Associate Veterinarian
Petco —Walnut Creek, CA
- $103,600 - $220,000 a year
- Full-time
- Fair chance
- Computer skills
- In-person
- Health insurance
- 401(k)
Assistant Director
Tutor Time Learning Centers —Fairfield, CA
- From $27.63 an hour
- Full-time
- Mid-level
- High school diploma or GED
- 21 years or older
- Disability insurance
- Health insurance
Quick Apply
Clinical Director (LMFT, LPCC, LCSW) - Mental Health 321
Telecare Corporation —Martinez, CA
- $108,905.47 - $134,542.23 a year
- Full-time
- LMFT
- Licensed Clinical Social Worker
- Adults
- Paid holidays
- Health insurance
Quick Apply
School Occupational Therapist- Full Time
Kadiant —Dixon, CA
- $120,000 - $130,000 a year
- Full-time
- School experience
- Classroom
- Word processing
- Health insurance
- Dental insurance
Quick Apply
10d
Supervisor, Procurement - IT Procurement
Inland Empire Health Plan —California
- $104,041.60 - $137,841.60 a year
- Full-time
- Hybrid work
- Office
- High school diploma or GED
- Supervising experience
- Disability insurance
- Health insurance
School Occupational Therapist
Kadiant —Dixon, CA
- $100 an hour
- Part-time
- School experience
- Classroom
- Word processing
- Opportunities for advancement
Quick Apply
10d
Director, Diagnostic Imaging
Northbay Healthcare —Fairfield, CA
- $200,000 - $225,000 a year
- Full-time
- Hospital
- Computer literacy
- 3 years
Physical Therapist (PT)
Powerback Rehabilitation —American Canyon, CA
- $60 - $65 an hour
- Full-time
- 5 years
- Physical & Rehabilitation Medicine
- Master's degree
- Relocation assistance
- Health insurance
Physical Therapist
Choice In Aging —Pleasant Hill, CA
- $52 - $58 an hour
- Full-time
- CPR Certification
- Clean driving record
- Experience working with individuals with disabilities
- Health savings account
- AD&D insurance
Quick Apply
3d
Funding Supervisor
National Seating & Mobility, Inc. —California
- Microsoft Outlook
- Mentoring
- Senior level
- Disability insurance
- 401(k)
Quick Apply
Special Education Program Manager - 1.0 FTE - District Office - 2026-2027 School Year
Vallejo City Unified School District —Vallejo, CA
- Full-time
- Experience working with individuals with disabilities
- Writing skills
- 3 years
Quick Apply
Relief Counselor- Napa
Progress Foundation —Napa, CA
- $20.25 an hour
- Part-time
- Bilingual
- Maintenance
- Discharge planning
Quick Apply
Polysomnographic Technologist (RPSGT)
Jiva Health —Vacaville, CA
- $30 - $38 an hour
- Overnight shift
- Background check
- CPR Certification
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
2d
Managing Veterinarian
National Veterinary Associates —Vacaville, CA
- $150,000 - $180,000 a year
- Email
- Management
- Fair chance
- Senior level
- Continuing education credits
- Relocation assistance

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care director jobs near fairfield, ca

Claims Resolution Coordinator

Partnership HealthPlan of California -
Fairfield, CA

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Job Details

Full-time
$37.22 - $46.53 an hour

Qualifications

ICD-9
Driver's License
Typing

Full Job Description

Overview:

To research and resolve complex claims issues which cross interdepartmental lines and communicate the outcome to providers and affected Partnership managers. Develops and maintains provider training materials for all lines of business. Conducts provider trainings across Partnership departmental lines in group or individual provider settings.

Responsibilities:

Answers customer service lines as necessary and responds to provider inquiries either by phone, email, or in person regarding claims related questions.
Reviews, researches, and works with various departments to resolve complex provider inquiries, appeals, and grievances.
Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Coordinates with Claims, Member Services, Health Services departments, the development, maintenance, and training of ongoing educational materials and tips for inclusion on the PHC website. Incorporates educational materials into the PR Manual and update on a quarterly basis.
Processes CIF's and adjustments as needed.
Writes and runs reports in Business Objects to obtain needed claim data.
Tracks and analyzes provider trends with denials and CIF's to provide support to providers with an opportunity to improve. Distributes provider scorecards.
Tracks complaints, appeals, and grievances by program. Reports activities on a quarterly basis to IQI, PHC Compliance Coordinator, and Claims Director.
Presents findings and recommendations for ongoing, long term resolutions to issues. Identifies items to address the “provider hassle factor.”
Acts as liaison and meets with designated staff from Claims, Health Services, Member Services, and QI departments to identify ongoing provider issues.
Coordinates system issues with Claims Configuration staff, IT staff, and PR Lead Project Specialist/Auditor. Leads or participates in special projects as needed.
Other duties as assigned

Qualifications:

Education and Experience

Minimum 1 year of experience in claims examining or customer service within healthcare, insurance, finance, or managed care environment; or equivalent combination of relevant experience and education.

Special Skills, Licenses and Certifications

Familiarity with Medi-Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic coding. Knowledge of Partnership Claim Policy and Procedures, Medi-Cal provider manual guidelines, Title 22 regulations and any other required policies, procedures, regulations, and manuals. Typing speed 30 wpm and proficient use of 10-key calculator. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business .

Performance Based Competencies

Ability to analyze and research claims issues. Excellent written and oral communication skills. Ability to present statistical and technical data in a clear and understandable manner. Good organization skills. Ability to work on multiple assignments simultaneously, prioritize work and complete projects within established time frames. Use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 37.22 - $ 46.53

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

care director jobs in fairfield, ca

Claims Resolution Coordinator

Area Manager, Primary and Urgent Care Clinics

Associate Director of Utilization Management

Medical Director - Hospice on-site Full time

Associate Veterinarian

Occupational Therapist (OT) – Home Health | East Bay Territories (FT & Per Diem) - $10,000 Sign on Bonus (FT)

Associate Veterinarian

Assistant Director

Clinical Director (LMFT, LPCC, LCSW) - Mental Health 321

School Occupational Therapist- Full Time

Supervisor, Procurement - IT Procurement

School Occupational Therapist

Director, Diagnostic Imaging

Physical Therapist (PT)

Physical Therapist

Funding Supervisor

Special Education Program Manager - 1.0 FTE - District Office - 2026-2027 School Year

Relief Counselor- Napa

Polysomnographic Technologist (RPSGT)

Managing Veterinarian

I want to receive the latest job alert for care director in fairfield, ca

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