Remote Medical Consultant I - Medi-Cal TAR Specialist
California Department of Health Services
The California Department of Health Care Services is seeking a Medical Consultant I to review Treatment Authorization Requests (TARs) and medical records for Medi-Cal beneficiaries. Under the supervision of the Medical Consultant II, you will provide medical adjudication support to field offices and headquarters nursing staff. This role requires statewide travel up to 5% for trainings and meetings; telework is available. #J-18808-Ljbffr
- ...Gainwell Technologies in California is hiring an Out-of-State Provider Specialist to support Medi-Cal by reviewing out-of-state claims and coordinating enrollment for providers. This 100% remote, full-time role requires strong analytical skills and familiarity with Medicaid...Remote workFull time
$22.12 - $27.93 per hour
...make a direct, lasting impact. As the Medi-Cal Specialist, you’ll help bring PACE (Program of All... ...Where you’ll work: Hybrid across home/remote, clinic, and community settings. Expect... ...Coverage that Fits Your Life: Choose from six medical plans, with up to 80% of premiums...Remote workTemporary workWork at officeLocal areaMonday to Friday- ...Qualfon is seeking detail-oriented Medi-Cal Claims Processing Specialists to review and resolve suspended claims accurately and efficiently in a home-based setup. Ideal candidates have knowledge of healthcare billing, strong analytical skills, and the ability to apply...Remote workWork from home
- ...California. This hybrid role requires strong analytical skills, knowledge of medical terminology, and the ability to coordinate with IPA/Medical groups and hospitals to deliver coordinated, high-quality Medi-Cal care while advancing health equity goals. #J-18808-Ljbffr...Suggested
- Amity Foundation is seeking a Medi-CAL Coordinator to screen individuals for Medi-CAL eligibility and coordinate placements across STOP and CALAIM programs in Los Angeles County. The role supports reentry and housing/resource connections, aligning participants with the...Suggested
- Gainwell Technologies is hiring for an Out-of-State Provider Specialist - Onsite - West Sacramento, CA. The role supports California's Medi-Cal program by reviewing out-of-state claims, coordinating provider enrollment, and ensuring accurate processing in line with program...
- ...Gainwell Technologies is seeking an experienced Claims Suspense Team Lead to support California's Medi-Cal program. This remote role leads a team of Claims Examiners, prioritizes suspended claims, and ensures timely review, pricing, and resolution in accordance with Medi...Remote work
- ...Gainwell Technologies is seeking an experienced Financial Cash Control Supervisor to lead the team supporting California’s Medi-Cal program. You will oversee accounts receivable, EFT enrollment, refunds, financial correspondence, and related transactions. You will...Remote work
$13.37k - $18.34k
...About this Role: Under direction of the Medical Consultant II (Supervisor), the Medical Consultant... ...on Treatment Authorization Requests (TARs) and medical records received from providers... ...California Medical Assistance Program (Medi-Cal). The MC I provides consultation to the...Remote workPermanent employmentFull timeContract workWork at officeNight shift- Gainwell Technologies is seeking an experienced Financial Cash Control Supervisor to support California's Medi-Cal program. You will oversee the Financial Cash Control team handling AR, EFTs, refunds, and related transactions, ensuring accuracy and timely processing. You...Remote job
- Qualfon is seeking a detail-oriented Medi-Cal Claims Processing Specialist to review and resolve suspended claims accurately and efficiently. The ideal... ...include verifying member eligibility, reviewing medical records and billing information, identifying and correcting...Remote job
- ...Financial Cash Control Team Lead to support California's Medi-Cal program in a remote role. You will lead AR operations, research and resolve complex financial issues, and ensure accurate processing of medical-related payments. Collaboration with DHCS, SCO, and vendors...Remote job
- ...Health Plan of San Joaquin is currently hiring a consultant Medical Director. This is a remote position; must reside in California. What You Will... ...according to HPSJ’s medical review criteria for both Medi-Cal and Dual Eligible Special Needs Plan (DSNP) members....Remote workContract workCurrently hiring
- ...Technologies is seeking an experienced Provider Field Representative to support healthcare providers across Central California for Medi-Cal. This remote, field-based role requires travel within the territory and strong training and education capabilities. You will conduct...Remote work
$30 - $45 per hour
...A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach... ...requires expertise in Medicaid and Medi-Cal operations, along with experience... ...metrics. This position is remote and offers a pay range of $30-$45...Remote workHourly payContract work- ...support healthcare providers across Central California as part of Medi‑Cal. You will be the primary contact for providers in your... ...reside in Central California and be willing to travel; the role is remote and field-based, with regular travel throughout the territory....Remote work
$130 per hour
...physicians: Must be board certified with current, active, unrestricted medical license Resident physicians: Must be in final year of residency... ...). Your specific rate is confirmed in your offer. Engagement Remote, 100% asynchronous 20 hrs/wk default (can be raised after...Remote workWeekly payWork at office- ...Maximus is hiring Bilingual Outreach CSRs (English/Spanish) in Mountain View, CA. This remote position focuses on educating beneficiaries about Medi-Cal managed care and guiding enrollment into health plans. The perfect candidate has a high school diploma and can navigate...Remote work
$70k - $75k
.... Summary As an Out-of-State Provider Specialist - Remote California at Gainwell, you will support California's Medi-Cal program by reviewing out-of-state healthcare... ...Process enrollment activities for out-of-state medical and outpatient providers, reviewing...Remote workFull timeWork at officeFlexible hours$24 per hour
...Medi-Cal Claims Processing Specialist Overview Qualfon is a global provider of omnichannel customer experience... ..., and covered benefits. Review medical records, claim documentation, and... ...internet service while working remotely. What We Offer We lead by...Remote workWork at officeLocal areaWork from home- ...Remote Description & Requirements Make a real difference in your... ...Bilingual Community Outreach Specialist (English/Spanish) in Hanford,... ...role, you’ll be the face of Medi-Cal managed care—connecting individuals... ...various plans, including Medical, Dental, Vision, Prescription...Remote workTemporary workLocal areaImmediate start
$22 - $24 per hour
...Location: Remote Employment Type: Full-Time Schedule: Monday–Friday... ...& Impact The Enrollment Specialist is responsible for helping prospective... ...are uninsured, have inactive Medi‑Cal coverage, have pending... ...justice‑involved, unhoused, or medically complex populations....Remote workHourly payFull timeLocal areaMonday to Friday- Gainwell Technologies is hiring for an Out-of-State Provider Specialist - Remote California. You will review OOS claims for Medi-Cal, coordinate enrollment activities for providers, and ensure accurate processing per program requirements. The role is 100% remote, requires...Remote job
- Gainwell Technologies LLC seeks an Out-of-State Provider Specialist - Remote California to support California's Medi-Cal program by reviewing out-of-state claims, coordinating provider enrollment, and ensuring accurate processing. This full-time, 100% remote role requires...Remote jobFull time
- Anchor Co-Living is seeking an Intake & Prior Authorization Specialist to convert incoming healthcare referrals into approved placements... ...managing referrals, documenting intake data, verifying Medi-Cal eligibility, and submitting prior authorizations while maintaining...Remote job
$90k - $100k
...in Clovis, California. This full-time, remote position offers a unique opportunity for... ...clinicians participate in regular case consultations and team meetings to enhance their clinical... ...timely documentation that aligns with Medi-Cal requirements and adheres to ethical standards...Remote workFull timeFlexible hours$60.78k
...Appeals and Grievances (A&G) Specialist II will receive, investigate... ...Health Care (DMHC), Managed Risk Medical Insurance Board (MBMIB) and... ...Care working with Medicare, Medi-Cal and other State Sponsored programs... ...weekends, holidays, a hybrid remote schedule, occasional...Remote workFull timeLocal areaShift workWeekend work- Position Summary The Enrollment Specialist is responsible for... ...commercial health plans, Medicare, Medi-Cal, and other applicable payers.... ..., healthcare administration, medical group operations, payer operations... ...performed in an office or remote administrative environment and...Remote workWork at office
- ...Blue Shield of California is seeking an Experienced Provider Relations Representative to support CalAIM by engaging with IPA/Medical groups, providers and hospitals to improve coordination and outcomes. You will help drive provider participation, maintain strong relationships...Work at office2 days per week
- State Controller's Office in Sacramento, California, is seeking a Post Issuance Technician III to process Post Issuance workloads in FI$Cal, generate daily reports, and provide expert guidance on post issuance procedures. The role requires strong attention to detail,...Remote workWork at officeShift work
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