Our FEP (Federal Employee Program) Customer Experience Teams receive incoming telephone calls from healthcare providers and active and retired Federal Employees. Call Centers are open Monday Friday from 8 00am to 4 30pm. This position is a hybrid remote position, not office based, which may require you to travel to the office a few times a year. If hired, you will be requ

Start dates from August 2024 October 2024 Mandatory Training Virtual As a Senior Markets Customer Service Representative (CSR), you are in charge of upholding our mission of providing service worthy of our family and friends. Our members look to you to help them navigate healthcare, providing empathy and advocacy. You are empowered to provide members with peace of mind th

Start dates from August 2024 October 2024 Mandatory Training Virtual As a Senior Markets Customer Service Representative (CSR), you are in charge of upholding our mission of providing service worthy of our family and friends. Our members look to you to help them navigate healthcare, providing empathy and advocacy. You are empowered to provide members with peace of mind th

Your Role The Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationship necessary to provide our members and clients with access to quality, affordable health care services. The Program Manager, Principal will report to the Director, Specialty Networks and Vendor Management. In this

Your Role The Network Management team is responsible for the development and maintenance of all provider networks, including vendor and Plan to Plan relationships necessary to provide our members and clients with access to quality, affordable health care services. The Senior Manager, Provider Services Network will report to the Director, Specialty Networks and Vendor Mana

Your Role The Promise Chief Medical Officer (CMO) team provides clinical and strategic leadership to ensure sustainable, scalable, and compliant operations with the aim of improving access, satisfaction, equity, and outcomes of the organization's Medi Cal members. The Promise CMO team is seeking a bright and well organized Program Coordinator with analytical and project m

Your Role The Salesforce Platform & Operations Team is focused on optimizing Salesforce solutions and maximizing value across the enterprise. Salesforce is an enterprise platform targeted to help accelerate our transformation program, enable innovation, and help realize our vision for a reimagined healthcare system. Our team works cross functionally to link our key busine

Your Role The Quality Review team completes internal audits of front line staff and vendors to ensure alignment with department processes and regulatory compliance. Quality Reviewers also provide coaching and work closely with business leaders to drive optimal results. The Manager of Quality Review will report to the Senior Manager of the Quality & Communications team. In

Your Role The Rapid Quality Improvement team is responsible for the development and execution of targeted, quality improvement initiatives in support of the commercial medical groups, hospitals, and affiliated providers to close gaps in care for our members. The Program Manager, Consultant will report to the Senior Manager, Quality Improvement. In this role you will execu

Your Role The Clinical Quality team oversees and is responsible of HEDIS medical record review, pursuit, and overall HEDIS submission. The Clinical Quality Coordinator will report to the Supervisor of the HEDIS Outreach Team. In this role you will be responsible for conducting provider outreach during the HEDIS season for medical record pursuit and retrieval. Also, partic

Your Role The Clinical Quality team oversees and is responsible of HEDIS medical record review, pursuit, and overall HEDIS submission. The Clinical Quality Coordinator will report to the Supervisor of the HEDIS Outreach Team. In this role you will be responsible for conducting provider outreach during the HEDIS season for medical record pursuit and retrieval. Also, partic

Your Role The Data & Analytics (D&A) team focuses enterprise wide to partner with business stakeholders to apply the power of data & analytics to deliver new insights and data driven solutions to accelerate business outcomes. The Medical Informatics Analyst, Principal will report to the Senior Manager, Medical Informatics (Value Based and Medical Care Solutions Analytics)

Your Role The Social Programs team is responsible for the support, oversight and administration of Social Programs benefits and services ensuring that our eligible members receive appropriate services in line with benefits and services that is member centered and in the communities where our members seek care. The Program Coordinator, Associate will report to the Senior M

Your Role The Data Services & Solutions, Data Governance team provide the framework, tools and oversight needed to standardize processes and procedures to govern data assets for world class data services and analytics. The Data Modeler, Consultant will report to the Sr. Manager, Data Governance. In this role you will engage in translating business concepts into conceptual

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M