Top 411 Managed care Jobs in Orange, Ca

Enrollment Representative
Champion Health Plan —Long Beach, CA
- From $23 an hour
- Overtime
- Background check
- Spanish
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
8d
Regional Care Biller - Centralized Billing Office (CBO)
Pursue Health LLC —Irvine, CA
- $32 an hour
- Full-time
- Background check
- Customer service
- Office
- Health insurance
- Dental insurance
Quick Apply
Revenue Cycle Specialist
Acacia Health —Irvine, CA
- $72,000 - $75,000 a year
- Full-time
- Research
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Care Manager LCSW
Providence Health and Services —Mission Viejo, CA
- $43.39 - $67.37 an hour
- 8 hour shift
- Acute care
- Licensed Clinical Social Worker
- Inpatient
- Paid parental leave
- Paid holidays
8d
Managed Care Coordinator
CHOC Children's —Orange, CA
- $64,355 - $106,184 a year
- Full-time
- Microsoft Word
- Mid-level
- High school diploma or GED
4d
Medical Records Collector (Remote)
Molina Healthcare —Orange, CA
- $20.34 - $30.39 an hour
- Full-time
- Remote
- Microsoft Excel
- Administrative experience
- Driver's License
- Health insurance
Program Manager, Community Health
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Customer service
- Tuition reimbursement
- Paid time off
Medical Case Manager, BHI Utilization Management - Covered California
CalOptima —Orange, CA
- Weekends as needed
- Background check
- LMFT
- Microsoft Outlook
- Tuition reimbursement
- Paid time off
Health Services Manager, Senior
County of Orange —Orange County, CA
- $140,670.40 - $194,833.60 a year
- Weekends as needed
- LMFT
- Microsoft Excel
- Microsoft Outlook
Collector I: Business Service-Managed Care
Hoag Health System —Costa Mesa, CA
- Full-time
- Customer service
- High school diploma or GED
- 1 year
- Employee discount
Inpatient Case Manager, LVN, Care Management, Full Time, Days
PIH HEALTH —Whittier, CA
- $33.35 - $55.75 an hour
- Full-time
- LVN
- Computer literacy
- Urgent Care
MANAGER, CONTRACT
Pomona Valley Hospital Medical Center —Pomona, CA
- $120,400 - $137,200 a year
- Full-time
- Hospital
- Research
- Mid-level
3d
Claims Resolution Specialist
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Writing skills
- Tuition reimbursement
- Paid time off
Managed Care Analyst - Capitation Revenue
Memorial Health Services —Fountain Valley, CA
- $38.36 - $55.61 an hour
- 8 hour shift
- Microsoft Excel
- Mid-level
- Finance
- Health insurance
Managed Care Network Coordinator - Managed Care - FT Days
University of California, Irvine —Orange, CA
- $97,000 - $182,200 a year
- Full-time
- Background check
- Microsoft Outlook
- 5 years
- Health insurance
- Retirement plan
Authorization Specialist
KPC GLOBAL MEDICAL CENTERS INC. —Santa Ana, CA
- $22.38 - $37.74 an hour
- Full-time
- Mid-level
- High school diploma or GED
- 2 years
Quick Apply
Contract Analyst
PIH HEALTH —Whittier, CA
- $66,060.80 - $108,992.00 a year
- Day shift
- Customer service
- Computer literacy
- Writing skills
Managed Care Specialist
Casa Colina Hospital and Centers for Healthcare —Pomona, CA
- $80,000 - $110,000 a year
- Full-time
- Hospital
- Mid-level
- Office
Quick Apply
Program Manager, Provider Network - Covered California
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Customer service
- Tuition reimbursement
- Paid time off
Discharge Planner
Garden Grove Hospital Medical Center —Garden Grove, CA
- $23.00 - $32.04 an hour
- Part-time
- Acute care
- LVN
- Hospital
- Health insurance
- Dental insurance

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Enrollment Representative

Champion Health Plan
Long Beach, CA

Quick Apply

Job Details

Full-time
From $23 an hour
8 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Customer communication
Interpersonal skills
Administrative experience
High school diploma or GED
Attention to detail
Problem-solving
Productivity software
Cross-functional collaboration

Full Job Description

Position Summary

Champion is seeking an experienced Enrollment Representative to support Medicare Advantage enrollment operations. This position is responsible for the accurate and timely processing of enrollment, eligibility, and membership transactions while ensuring compliance with CMS regulations and company policies.

The ideal candidate has experience in Medicare Advantage or managed care enrollment, enjoys working in a fast-paced environment, and is committed to accuracy, compliance, and exceptional customer service.

Responsibilities

As an Enrollment Representative, you will:

Process Medicare Advantage enrollment, disenrollment, eligibility, and membership transactions accurately and within required turnaround times.
Review enrollment applications and supporting documentation for completeness, accuracy, and CMS compliance.
Verify Medicare eligibility and required enrollment documentation.
Enter, maintain, and update member information in enrollment systems.
Process enrollment corrections, retroactive enrollments, eligibility updates, reconciliations, and membership adjustments.
Conduct outbound member outreach, including Outbound Enrollment Verification (OEV) calls, to verify enrollment requests, obtain missing information, resolve discrepancies, and support CMS compliance requirements.
Research and resolve enrollment discrepancies, transaction errors, and eligibility issues.
Maintain accurate electronic documentation to support regulatory compliance and audit readiness.
Respond to enrollment-related inquiries from members, brokers, providers, and internal departments.
Partner with Member Services, Broker Relations, Marketing, Compliance, and other departments to resolve enrollment issues efficiently.
Protect confidential member information and comply with HIPAA, CMS, and Fraud, Waste & Abuse (FWA) requirements.
Participate in quality audits, training, and process improvement activities.
Support departmental operations during Annual Enrollment Period (AEP), Open Enrollment Period (OEP), and other peak enrollment periods.
Other duties as assigned.

Qualifications

Required

High School Diploma or GED.
Minimum 3 year of experience in Medicare Advantage, managed care, health plan enrollment, eligibility, customer service, or a related healthcare administrative role.
Strong attention to detail and commitment to accuracy.
Excellent organizational, analytical, and problem-solving skills.
Effective verbal and written communication skills.
Ability to manage multiple priorities while meeting deadlines.
Ability to work effectively as part of a team and collaborate respectfully with coworkers, supervisors, and other departments.
Ability to receive, understand, and follow instructions, established procedures, coaching, and supervisory direction.
Flexibility to work overtime and weekends, as requested, during AEP, OEP, and other high-volume or peak operational periods.
Proficiency with Microsoft Office applications.

Preferred

Experience working in a CMS-regulated healthcare environment.
Knowledge of Medicare Advantage enrollment processes and CMS regulations.
Experience with enrollment and eligibility systems.
Bilingual (English/Spanish) is a plus.

Pay: From $23.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

managed care jobs in orange, ca

Enrollment Representative

Regional Care Biller - Centralized Billing Office (CBO)

Revenue Cycle Specialist

Care Manager LCSW

Managed Care Coordinator

Medical Records Collector (Remote)

Program Manager, Community Health

Medical Case Manager, BHI Utilization Management - Covered California

Health Services Manager, Senior

Collector I: Business Service-Managed Care

Inpatient Case Manager, LVN, Care Management, Full Time, Days

MANAGER, CONTRACT

Claims Resolution Specialist

Managed Care Analyst - Capitation Revenue

Managed Care Network Coordinator - Managed Care - FT Days

Authorization Specialist

Contract Analyst

Managed Care Specialist

Program Manager, Provider Network - Covered California

Discharge Planner

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