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102 alameda alliance for health jobs in Alameda, CA

Inpatient Utilization Management Reviewer – new

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Perform timely concurrent review of inpatient admission to ensure it meets medical necessity guidelines. • Provide weekend coverage… Beyond.com

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Lead Claims Analyst – new

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Review and process complex claims that are outside the scope of normal claims processing, requiring more in-depth understanding of… Beyond.com

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Claims Benefit Analyst

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Translate provider contracts and Alliance benefit evidence of coverage for all lines of business into applicable codes (CPT, HCPCS… Beyond.com

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Manager, Claims Quality

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Supervise Claims Auditors, Claims Benefit Analyst, Claims Operations Trainer, Quality Specialist and Oversight Specialist. • Identify… Beyond.com

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Claims Customer Services Representative

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Answer claims customer service phones daily. • Disseminate claim information to contracted and non-contracted Alliance providers… Beyond.com

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Senior Manager, Case Managment

Alameda Alliance for Health 8 Reviews Alameda, CA

INCLUDE: * Oversee the programs in Case and Disease Management to include, but not limited to, Diabetes Management, Asthma Management, Care… Beyond.com

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Lead Claims Processor

Alameda Alliance for Health 8 Reviews Alameda, CA

• Contribute to creating and updating of departmental Policies and Procedures (P&Ps). • Responsible in providing assistance in… Beyond.com

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Claims Auditor

Alameda Alliance for Health 8 Reviews Alameda, CA

report to the Director, Claims of all departmental errors. • Prepare a weekly list of common errors to the Director, Claims, and Manager, Claims… Beyond.com

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Manager, Applications

Alameda Alliance for Health 8 Reviews Alameda, CA

The Manager, Applications will document and review all software system functions and configurations that they are responsible for and ensure that all… Beyond.com

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Reporting Data Analyst/Developer

Alameda Alliance for Health 8 Reviews Alameda, CA

INCLUDE: * Business Objects administration - design, configuration, optimization and maintenance of the Business Objects environment. * Design… Beyond.com

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Clinical RN Specialist

Alameda Alliance for Health 8 Reviews Alameda, CA

• Research and analyze complex issues. Acquire and review case against… Beyond.com

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Healthcare Analyst, Quality Improvement

Alameda Alliance for Health 8 Reviews Alameda, CA

INCLUDE: * Prepare, analyze, and report data to evaluate performance in key quality of care and service indicators. * Manage and… Beyond.com

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Claims Analyst

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Review and process complex claims that are outside the scope of normal claims processing, requiring more in-depth understanding of… Beyond.com

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IT Service Desk Technician - Network

Alameda Alliance for Health 8 Reviews Alameda, CA

include functioning as first level support for the IT Service Desk by responding to, and addressing all calls for assistance with computer problems… Beyond.com

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Claims Recovery Specialist

Alameda Alliance for Health 8 Reviews Alameda, CA

include: • Review and analyze system generated reports to determine recovery opportunities. • Keep current on CMS, DHCS, DMHC regulations and AAH… Beyond.com

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