Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Lead Configuration Information Management - Claims & Rules

Molina Healthcare of Illinois

Molina Healthcare is seeking a Lead Analyst for configuration information management in Long Beach, California. This role involves analyzing data, managing coding and benefit plans, and collaborating with stakeholders to meet business objectives. The ideal candidate has over 5 years in health care operations, advanced experience with claims processing systems, and strong analytical and communication skills. Competitive benefits and compensation are offered. #J-18808-Ljbffr

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Lead Configuration Information Management - Claims & Rules in Long Beach, CA vacancy
  • $59.81k - $129.59k

     ...DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible for...  ...of critical information on claims databases, synchronizing operational...  ...and application of business rules as they apply to each database,... 
    Claims
    Work experience placement
    Work at office

    Molina Healthcare

    Long Beach, CA
    2 days ago
  • $51.06 - $73.9 per hour

     ...Program Lead, QNXT Implementation - SCAN...  ...implementation of the Claims workstream within...  ...product managers for Claims, Provider Data, and Configuration (including provider...  ...benefits, UM/business rules, and capitation),...  ...Health Administration, Information Systems, or... 
    Claims
    Hourly pay
    Temporary work
    Work at office
    Remote work

    SCAN

    Long Beach, CA
    1 day ago
  •  ...Lead Analyst The Lead Analyst serves as a data steward with deep...  ...healthcare data (eligibility, claims, auths etc.) Acts as the...  ...business definitions, data logic and rules. Apply deep subject matter...  ..., and strategic decisions to Manager/Director. Operates... 
    Claims
    Remote work

    Molina Healthcare

    Long Beach, CA
    2 days ago
  •  ...Job Title Provides lead level analyst support for health...  ...(PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute...  ...integrity (PI) solutions. Manages scorable action items (SAIs...  .../state Medicaid payment rules. Strong data analysis/queries... 
    Claims
    Temporary work
    Work at office
    Remote work

    Molina Healthcare

    Long Beach, CA
    3 days ago
  • $14.76 - $31.97 per hour

     ...JOB DESCRIPTION Job Summary Provides lead level support for core operations activities including claims processing, benefit interpretation, provider services,...  ...compliance. Essential Job Duties Effectively manages escalations within the department by ensuring... 
    Claims
    Hourly pay
    Work experience placement
    Work at office

    Molina Healthcare

    Long Beach, CA
    2 days ago
  • $49.43k - $107.1k

     ...maintenance of critical provider information on all claims and provider databases....  ...application of business rules as they apply to each...  ...pertains to contracting, network management and credentialing....  ...feedback. Assists in complex configuration issues and loading of... 
    Claims
    Work experience placement
    Work at office

    Molina Healthcare

    Long Beach, CA
    1 day ago
  • $95 per hour

     ...Consulting is seeking an experienced IT Project Manager for a contract role focused on implementing a core claims processing platform. The ideal candidate has over...  ...expert in claims platforms. Responsibilities include leading the technical implementation, managing vendor... 
    Claims
    Contract work
    Remote work

    DeWinter Group

    Long Beach, CA
    1 day ago
  •  ...Summary The Provider Configuration Supervisor is responsible for leading and overseeing all...  ...within the claims adjudication system...  ...and claims payment rules are configured...  ...and amendments. Manage retroactive configuration...  ..., Finance, Information Systems, or related... 
    Claims
    Contract work
    Flexible hours

    Advanced Medical Management, Inc.

    Long Beach, CA
    2 days ago
  • $60k

     ...button and follow the next steps. As a claims specialist on our team, you'll play a...  ...and others involved in the accident. The information gathered will then be used while determining...  ...task and prioritize Knowledge of the rules of civil procedures in terms of filing/... 
    Claims
    Work experience placement
    Work at office

    National Guard Employment Network

    Torrance, CA
    4 days ago
  • $51.06 - $73.9 per hour

     ...Senior Manager Payment Integrity SCAN began...  ...functional system configuration team which...  ..., Authorizations, Claims, Encounters, Member...  ...You Will Leads the coordination,...  ...retired configuration rules, the source of the...  ..., and summarizing information and trends. Attends... 
    Claims
    Hourly pay
    Temporary work
    Work at office
    Remote work

    SCAN

    Long Beach, CA
    4 days ago
  • $34.47 - $49.97 per hour

     ...Product Manager, QNXT Implementation - SCAN...  ...approaches for the Claims workstream as part...  ...Provider Data, and Configuration, including...  ...benefits, UM/business rules, and capitation, as...  ...well as the program lead and subject matter...  ...Health Administration, Information Systems, or... 
    Claims
    Hourly pay
    Temporary work
    Work at office
    Remote work

    SCAN

    Long Beach, CA
    5 days ago
  • $106.2k - $182.98k

     ...alignment, and solution design across Care Management, Utilization Management, Pharmacy,...  ...measurable improvements in member outcomes. Lead cross functional discovery and...  ...across CCD/C‑CDA, ADT, labs, pharmacy, and claims with strong FHIR/HL7/X12 skills and coding... 
    Claims
    Work experience placement

    SCAN

    Long Beach, CA
    5 days ago
  • $120k - $130k

     ...an Oracle Fusion Functional Lead - SCM & Finance to provide hands...  ..., and production support. Configuration and development work is...  ...Oracle Fusion Module Coverage information below) - Develop a strong...  ...inventory, procurement, and order management - Translate business... 
    3 days per week

    Treehouse Partners

    Carson, CA
    5 days ago
  • $68k - $74k

     ...Description Role Overview Chili's Managers are wired for hospitality! We're in the...  ...know how to have fun along the way. From leading the team through a high-energy shift to...  ...Texas in 1975. Since then, we've boldly claimed our place in the casual dining industry... 
    Claims
    Casual work
    Shift work

    Chili's

    Carson, CA
    18 days ago
  • $14.76 - $31.97 per hour

     ...Summary Provides support for claims activities including...  ...findings accordingly (includes information on trends as requested)....  ..., fee schedules and systems configurations, to determine root causes of...  ...Qualifications At least 2 years of managed care experience in a call... 
    Claims
    Hourly pay
    Contract work
    Work experience placement
    Work at office

    Molina Healthcare

    Long Beach, CA
    1 day ago
  • $30 - $50 per hour

     ...manufacturing lies not in automation, but in configuration. We supercharge electrical wire...  ...builds at record-breaking speed. As a Lead Technician, you will be the 1st line of...  ...Proficiency with ERP/MRP systems, work order management, and BOM structures.  Excellent... 
    Hourly pay
    Permanent employment
    Contract work
    Work at office
    Local area
    Flexible hours
    Weekend work

    Senra Systems

    Cypress, CA
    13 days ago
  • $135.15k - $182.85k

     ...Payloads Engineer (Senior or Lead) Company: The Boeing...  ...to completion, leading risk management, assessing scope changes and...  ...to certification or to configuration control, and by defining overall...  ...Present engineering technical information in customer and supplier... 
    Permanent employment
    Work experience placement
    Relocation
    Visa sponsorship
    Work visa
    Flexible hours
    Shift work

    Boeing

    Long Beach, CA
    4 days ago
  •  ...Title Provides analyst support for configuration oversight activities. Responsible for...  ...and maintenance of critical information on claims/provider databases, validating data housed...  ...pertains to provider contracting, network management, credentialing, benefits, prior... 
    Claims
    Work at office
    Remote work

    Molina Healthcare

    Long Beach, CA
    2 days ago
  •  ...prominent insurance brokerage is seeking a Vice President of Bill Review and Managed Care to oversee medical cost containment programs. This role requires a Bachelor's degree and extensive claims management experience, preferably over 10 years, along with an active... 
    Claims
    Remote work

    Gallagher

    Torrance, CA
    1 day ago
  •  ...A leading claims adjusting firm is seeking Independent Insurance Claims Adjusters in California. This opportunity involves assisting clients through the claims process after disasters. Ideal candidates will be licensed adjusters with experience handling multiple claims... 
    Claims

    MileHigh Adjusters Houston

    Compton, CA
    1 day ago
  •  ...Job Description: Must have skills: QNXT - Claims, QNXT-Membership and QNXT Provider - 4...  ...Membership, Claims, Billing etc) Needed. Configuration experience in QNXT is added advantage...  ...Azure Cloud would be added advantage Lead Skills: Playing team lead role... 
    Claims

    Omni Inclusive

    Long Beach, CA
    5 days ago
  •  ...Job Description POSITION SUMMARY The Configuration Analyst I will be responsible for...  ...programmed accurately for Authorizations and Claims. RESPONSIBILITIES-DUTIES Configure...  ...Supervisor of Contract Configuration or Manager of Contract Configuration. Ability to... 
    Claims
    Contract work
    Work at office
    Flexible hours

    Advanced Medical Management, Inc.

    Long Beach, CA
    3 days ago
  •  ...assemblies prior to assembly to obtain required configurations or positions for welding, using...  ...identity, gender expression, genetic information, physical or mental disability, military...  ...established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 668; 43 U.S.C.... 
    Claims
    Contract work
    Shift work

    Sealaska

    Signal Hill, CA
    3 days ago
  • $96.05k - $129.95k

     ...Manufacturing Engineer (Experienced and Lead Level) Company: The Boeing...  ...~4 + years' experience in Production Configuration Management. ~4 + years' experience in a Manufacturing...  ...policies. General: All information provided will be checked and may be... 
    Permanent employment
    Work experience placement
    Currently hiring
    Immediate start
    Relocation
    Visa sponsorship
    Work visa
    Relocation package
    Flexible hours
    Shift work

    Boeing

    Long Beach, CA
    5 days ago
  •  ...Independent Insurance Claims Adjusters Needed Now Is it time for a career change? Independent insurance claims adjusters are needed now! Are you ready to embark on a dynamic and in-demand career as an independent insurance claims adjuster? This is your chance to join... 
    Claims

    MileHigh Adjusters Houston

    Long Beach, CA
    3 days ago
  •  ...analysis of complex healthcare claims data, pharmacy data, and...  ...utilization and cost containment information. Evaluates, writes, and...  ...solutions while overseeing and managing the activities of assigned...  ...Claims, Utilization Management. Configuration and Payment Integrity to... 
    Claims
    Contract work
    Remote work

    Molina Healthcare

    Long Beach, CA
    1 day ago
  •  ..._______________ Manager is looking for a candidate...  ...that can support AP Claims, CRM, and a bit of UM....  ...at least 6 years of configuration experience. Demonstrate proficiency with information systems technology, which...  ...Bhupesh Khurana Lead Technical Recruiter... 
    Claims
    Temporary work
    Work at office
    Local area
    Remote work

    Amerit Consulting

    Long Beach, CA
    2 days ago
  • $23 per hour

     ...a full-time Community Manager position. Compensation...  ...and properly direct claims, incident reports and assist...  ...and accurate safety information manuals, provide all residents...  ...and follow posted work rules and procedures....  ...criticism. Ability to lead and manage others.... 
    Claims
    Hourly pay
    Full time
    Contract work
    For contractors
    Immediate start
    Flexible hours

    Birtcher Anderson & Davis

    Garden Grove, CA
    2 days ago
  • $34.47 - $49.87 per hour

     ...Job The Senior Configurations Specialist QNXT - SCAN...  ...knowledge sharing. Will lead initiatives to improve...  ...for IKA & QNXT claims processing improvement...  ...owners and Shared Services Management. Maintain accurate...  ...proposed changes, making informed recommendations, and... 
    Claims
    Hourly pay
    Temporary work
    For contractors
    Work at office
    Remote work

    Scangroup

    Long Beach, CA
    4 days ago
  •  ...serve as our Senior Director of MSO – Claims Operations & Provider Configuration. This position requires candidates...  ...market expansion Performance Management & Operational Improvement Improve...  ...underpayment, and compliance risk Lead audit readiness for CMS and health... 
    Claims
    Contract work
    Flexible hours

    Advanced Medical Management

    Long Beach, CA
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Lead Configuration Information Management - Claims & Rules. Be the first to apply!