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At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate
Posted Today
At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate
Posted Today
At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate
Posted Today
Help develop enterprise wide Integrated Network teams that focus on specific pharmacy areas/service lines such as reporting or customer service Develop and distribute contract amendments, and collaborate with peers to develop contract language to meet evolving client needs and regulations Update OptumRx Provider Manual, and manage reviews and distribution of the manual Perform network analysis and
Posted Today
Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls Identify potential contract issues and impacts on the business. Builds relationships that nurture Hospital, Physician, Pharmacy, or Ancillary Provider partnerships and seeks broader value based business opportunities to support the local market strateg
Posted Today
Assist in end to end provider claims and help enhance call quality Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Support development and management of provider networks Help implement training and deve
Posted Today
Drafting, evaluating, negotiating, and finalizing new business opportunities, client contracts within established standards Serving as the point of contact for internal customers on contractual matters, providing redlined recommendations, and negotiating directly with our external customers in partnership with business. Reviewing and analyzing RFPs to support business growth initiatives Administer
Posted Today
Handling escalated provider claim and service issues and provider engagement activities that directly impact satisfaction and increase provider Net Promoter Score (NPS) The position supports provider face to face engagement, education and training, including communications, live presentations, and information available to the provider network Provider Medi Cal trainings and ongoing education as gu
Posted Today
Telephonic Provider Education Front Line support to help resolve provider issues Oversees provider TIN demographic changes Assists with recovery of incomplete provider documentation Assist with administrative tasks, ISET and Scion Tickets Claim Escalation assistance Assists with member placement and escalations Associate Dental Provider Adds Prioritize and organize own work to meet deadlin
Posted Today
Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review Handle resolution/inqu
Posted Today
BOARDRIDERS
- Huntington Beach, CA
This position is to support the Licensing team with calendar management, sample/product approvals, catalogue creation and GTM coordination across all Boardriders brands. This position reports to the Director of Licensing. This position is based in our Huntington Beach, CA office. RESPONSIBILITIES General administration, file organization, and invoicing Calendar development and adherence Sample gat
Posted Today
Company Description As the world's leader in digital payments technology, Visa's mission is to connect the world through the most creative, reliable and secure payment network enabling individuals, businesses, and economies to thrive. Our advanced global processing network, VisaNet, provides secure and reliable payments around the world, and is capable of handling more than 65,000 transaction mess
Posted Today
LPL Financial
- San Diego, CA / Fort Mill, SC
Do you find the world of life underwriting, algorithms, and mortality risk assessments fascinating? Do you enjoy educating, coaching, and guiding financial advisors through the life pricing process? Are you someone that is talented at coming up with different options around an impasse and back on track to a goal? Do you enjoy collaborating with different teams at multiple life sponsors, paramedica
Posted Today
Must be able to fill in for the Quality Supervisor/Manager for defined periods of time when needed. Must be able to perform all Quality Inspector duties and responsibilities. Schedule and perform daily random inspections of raw materials in the Receiving area, work in process in the Production lines, and finished goods in the Final Inspection area. Ensure that quality standards are met in all area
Posted Today
Crawford & Company
- San Diego, CA / Temecula, CA
Property General Adjuster Requisition ID 2021 12462 Job Locations US CA San Diego | US CA Temecula Position Type Regular Full Time Category Claims Business Unit Crawford Claims Solutions Excellence In Everything We Touch Position Summary Adjust highly complex residential and commercial property claims with heavy losses. Responsibilities Examine claim forms, policies/endorsements, and client ins
Posted Today
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