Jobs near Woodland Hills: 4,248
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Relevance Score ranked on: COMPENSATION
Clinical Ops Medical Director
WOODLAND HILLS, 21215 BURBANK BLVD
Ensures timely completion of clinical case reviews for their board certified specialty. Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested. Makes medical necessity determinations for grievance and appea...
Search Terms: Medical Director, Clinical, Director, Medical, Healthcare
68.7
0mi
Updated: November 28
Investigator Senior
WOODLAND HILLS, 21215 BURBANK BLVD
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsible for independently identifying and developing enterprise-wide specific healthcare investigatio...
Search Terms: Investigator, Senior, Healthcare, Technology, Benefits
68.7
0mi
Updated: November 28
Manager I GBD Special Programs
WOODLAND HILLS
Manager I GBD Special Programs. Office Location: 21215 Burbank Blvd, Woodland Hills, CA 91367. Office Requirement: This position will take part in Elevance Health's hybrid workforce strategy which includes virtual work and 1-2 days physically in office per week. The Manager I GBD Special Programs is ...
Search Terms: Manager, Behavioral Health, Program, Healthcare, Benefits
68.3
0mi
Updated: November 27
Membership Representative I
WOODLAND HILLS, 21215 BURBANK BLVD
Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. Verifies enrollment status, makes changes to records, researches and resolves enrollment system...
Search Terms: Membership, Representative, Benefits, Retail, Healthcare
67.3
0mi
Updated: November 22
CareMore Care Manager
WOODLAND HILLS, 21215 BURBANK BLVD
Primary duties may include, but are not limited to:Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs. Supports member or their representative in regard to care, care transitions, and changes in heal...
Search Terms: Care Manager, Manager, Healthcare, Health, Patient
67
0mi
Updated: November 20
Director, Total Rewards and HRIS
Culver City
Develop and administer Jam City’s global base pay, short-term and long-term incentive programs. Advise the executive team, global Talent Acquisition and People Business Partners on pay decisions and guideline interpretations. Manage the job and pay structure and provide expertise and counsel to HR co...
Search Terms: Total Rewards, HRIS, Director, Talent Acquisition, Rewards
66.7
16mi
Updated: November 25
Business Information Consultant
WOODLAND HILLS, 21215 BURBANK BLVD
Creates and maintains databases to track business performance. Analyzes data and summarizes performance using summary statistical procedures. Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and...
Search Terms: Business, Consultant, Information, Technology, Healthcare
66.6
0mi
Updated: November 16
Group Underwriting Consultant Sr.
WOODLAND HILLS, 21215 BURBANK BLVD
Group Underwriter Consultant, Sr. Location: Open to anywhere in the contiguous US - This position will take part in Elevance Health's hybrid workforce strategy which includes virtual work and 1-2 days in office per week. Specific requirements and expectations for time on site will be discussed as par...
Search Terms: Underwriting Consultant, Underwriting, Consultant, Technology, Healthcare
66.5
0mi
Updated: November 14
Clinical Fraud Investigator II - SIU Fraud & Abuse
WOODLAND HILLS, 21215 BURBANK BLVD
Conducts data mining activities using available tools and internal data warehouse. Performs comprehensive analysis and clinical evaluation of the collected data. Performs in-depth investigations on identified providers as warranted. Examines claims for compliance with relevant billing and processing ...
Search Terms: Fraud, Clinical, Investigator, Healthcare, Benefits
66.3
0mi
Updated: November 12
Provider Payment Appeal Analyst I
Woodland Hills
Reviews and analyzes provider requests to investigate the outcome of a Reconsideration. Considers all information when determining whether to uphold or overturn primary decision. Works with various departments including Provider Solutions and Health Plan Operations leadership when necessary, to deter...
Search Terms: Analyst, Payment, Operations, Technology, Healthcare
66.1
0mi
Updated: November 08
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