Medasource
Location
Pasadena, CA | United States
Job description
Position Title: Implementation Consultant – Community Support (Claims)
Contract Length: EOY 2024
Start date: ASAP
Location: Los Angeles Greater Area (Pasadena on-site once per week preferred)
Overview: This role will support our client's Medi-Cal expansion and compliance with DHCS requirements.
Responsibilities:
Acclimating members to the Medi-Cal model
Handling operationalization and implementation mutually to work cohesively
Communicating between the Claims team and the Medi-Cal team
Working with referrals, authorizations, and HCPCS codes
Managing external and internal stakeholders effectively
Required Experience:
5-10 years of Claims experience with a Health Plan or Planned Partner
Experience working between Health Plans and Community-Base Organizations, risk modeling, social determinants
Experience in Community Supports and other CalAIM initiatives
Program Management experience in community health
Bachelors Degree or higher education
Ability to communicate between multiple, diverse stakeholders
Someone who is enthusiastic and ready to hit the ground running
Tenacity – passion, drive, and commitment to the positive outcomes
Preferred:
Experience managing highly complex projects/programs with multiple stakeholders
Experience with Claims support
Experience with UM functions such as authorizations, denials, notice of action letters
Member center design skillset
Master's Degree or equivalent work experience
Medasource provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.
JO-2402-143065
Job tags
Salary
