Company Description At Coffman Engineers, we serve as both prime consultant and sub consultant on projects large and small, including commercial, retail, institutional, government, industrial, and project/construction management. Incorporated in 1979, we have employees in more than 20locations serving clients across the United States and overseas. To meet client objectives

Your Role The Special Investigations Unit team is responsible for preventing, detecting, investigating, and resolving health care fraud, waste, and abuse . The Special Investigations Investigator, Consultant will report to the SIU Manager. In this role you will represent a high level of professionalism both internally and externally. Conduct investigations in accordance w

Your Work In this role, you will Be responsible for analytic work required to convert pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Build and update models that allow the actuarial team to quantify financial gaps and opportunities at a provider level Conduct and devel

Your Work In this role, you will Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Create value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy Create value for th

Conduct on site inspections and assessments of property damages for both residential and commercial claims Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions

Your Role The Population Health Management (PHM) Governance team, under the state mandate of the California Advancing and Innovating Medi Cal (CalAIM) program, is designed to proactively assess and address the care needs of beneficiaries with tailored interventions. The Business Analyst, Consultant will report to the Sr. Manager, Governance, Population Health Management.

Your Role The Network Management and Provider Partnerships team is responsible for supporting Enterprise led mandates and managing all Business led mandates. The Program Manager, Principal will oversee the intake, review, and impact assessment for all mandates to determine what Network Management teams may be impacted. This role will ensure appropriate representation from

Workers' Compensation Matter Coordinator Job Locations US CA Woodland Hills Requisition ID 2024 16706 Category Legal Position Type Regular Full Time Overview If you have a deep understanding of California Workers ' Compensation law and are looking to join a dynamic team of professionals, we encourage you to apply for this position. As a Workers Compensation Matter Coordin

Duties WHAT IS THE INFORMATION TECHNOLOGY (IT) DIVISION? A description of the business units can be found at Vacancies will be filled in the following specialty areas Information Technology Applications Development The following are the duties of this position at the full working level. Performs extensive operational reviews, prepares comprehensive program analyses/evalua

Your Role The Medical Care Solutions Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Request. The Clinical Services Coordinator will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise lines of business. Your Work In this role,

Duties WHAT IS THE HUMAN CAPITAL OFFICE DIVISION? A description of the business units can be found at Vacancies will be filled in the following specialty areas Human Capital Office of Human Resource Strategy Enterprise Talent Development. 5 positions to be filled in HCO, Enterprise Talent Development. The following are the duties of this position at the full working level

Your Role The Federal Employee Program team is responsible for Federal Employee Health Benefits and serves all federal employee is the state of California. The Account Manager Federal Employee Program, Senior Central Valley will report to the Senior Manager, Account Management, FEP. In this role you will be primarily responsible for the sales, retention, and support of go

Your Role The ACA Chart Program team conducts the following functions (1) identify medical records with unreported diagnosis codes, (2) retrieve those medical charts, (3) perform medical coding to convert them into risk adjustable diagnosis codes, and (4) submit to CMS via the EDGE pathway . The Risk Adjustment, Consultant will report to the Senior Manager . In this role

As a Contract Management Specialist, you will join a team responsible for overseeing the day to day management of our proposal and contract management process. You will be responsible for quality assurance reviews of customer proposals and/or Statements of Work. Ensuring accuracy, completeness and compliance with our internal control policies and quality standards (legal,

Position Summary The General Service Technician must have a mechanical aptitude and is able to perform basic automotive services including mounting and balancing tires, tire repairs, oil changes, vehicle inspections and other less technical services while delivering an excellent customer experience. Responsible also to maintain clean and safe work areas in the tire and ser