Sự Nghiệp

Sự Nghiệp

Sự Nghiệp Với Astiva Health

Chúng tôi rất sẵn lòng tạo cơ hội cho quý vị bán các sản phẩm tốt nhất tại Quận San Diego và Quận Cam.

Bắt đầu sự nghiệp với Astiva Health sẽ cho quý vị cơ hội có một việc làm ổn định trong lúc trợ giúp người khác vui hưởng cuộc sống trọn vẹn. Chúng tôi rất hãnh diện phục vụ cho một cộng đồng trải rộng và đa dạng qua việc chữa lành, và chúng tôi rất mong quý vị sẽ sát cánh cùng chúng tôi trên hành trình cải thiện việc chăm sóc sức khỏe cho mọi người.

Các vị trí đang tuyển dụng (bằng tiếng Anh):
Open positions
   Claims Examiner
  • Responsible for manual input and adjudication of MSO claims.
  • Interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts.
  • Data enter paper claims into EZCAP.
  • Strong working knowledge of Medicare and Medi-Cal, OPPS APC, Ambulatory Surgery pricing, and RBRVS payment guideline.
   Utilization Management Coordinator
  • Under the direction of UM Director and CMO processes Prior Authorization-Referral requests that are received from PCPs and-or Specialty Providers.
  • Understand and follows UM policies and procedure pertaining to referral process.
  • Works with Membership Management and Claims and Contract Departments on an as needed basis
  • Verifies that the patient address in EZCAP corresponds with prior authorization/referral process.
   Director of Utilization Management
  • Analyzes UM data to identify trends and recommend interventions to the Medical Director.
  • Assesses clinical and operational policies and procedures annually; revises and implements as appropriate.
  • Prepares and manages regulatory audits and responds to departmental inquiries from the DMHC and CMS.
  • Works with the finance and claims department to improve processes in the UM department such as turnaround times for authorizations, denial letters and member notification of services.
   Director of Member Services
  • Leads the Member Call Center and Appeals & Grievance teams
  • Provides guidance and leadership to the Member Experience department by directly supervising employees.
  • Develop and implement policies & procedures to ensure all compliance requirements are met.
  • Use customer insight and root cause analytics to identify organization wide improvements and present these plans to leadership and peers.
Interested, apply by email resume to: Christopher.vo@astivahealth.com
Sự Nghiệp Với Astiva Health

Chúng tôi rất sẵn lòng tạo cơ hội cho quý vị bán các sản phẩm tốt nhất tại Quận San Diego và Quận Cam.

Bắt đầu sự nghiệp với Astiva Health sẽ cho quý vị cơ hội có một việc làm ổn định trong lúc trợ giúp người khác vui hưởng cuộc sống trọn vẹn. Chúng tôi rất hãnh diện phục vụ cho một cộng đồng trải rộng và đa dạng qua việc chữa lành, và chúng tôi rất mong quý vị sẽ sát cánh cùng chúng tôi trên hành trình cải thiện việc chăm sóc sức khỏe cho mọi người.

Các vị trí đang tuyển dụng (bằng tiếng Anh):
Open positions
   Claims Examiner
  • Responsible for manual input and adjudication of MSO claims.
  • Interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts.
  • Data enter paper claims into EZCAP.
  • Strong working knowledge of Medicare and Medi-Cal, OPPS APC, Ambulatory Surgery pricing, and RBRVS payment guideline.
   Utilization Management Coordinator
  • Under the direction of UM Director and CMO processes Prior Authorization-Referral requests that are received from PCPs and-or Specialty Providers.
  • Understand and follows UM policies and procedure pertaining to referral process.
  • Works with Membership Management and Claims and Contract Departments on an as needed basis
  • Verifies that the patient address in EZCAP corresponds with prior authorization/referral process.
   Director of Utilization Management
  • Analyzes UM data to identify trends and recommend interventions to the Medical Director.
  • Assesses clinical and operational policies and procedures annually; revises and implements as appropriate.
  • Prepares and manages regulatory audits and responds to departmental inquiries from the DMHC and CMS.
  • Works with the finance and claims department to improve processes in the UM department such as turnaround times for authorizations, denial letters and member notification of services.
   Director of Member Services
  • Leads the Member Call Center and Appeals & Grievance teams
  • Provides guidance and leadership to the Member Experience department by directly supervising employees.
  • Develop and implement policies & procedures to ensure all compliance requirements are met.
  • Use customer insight and root cause analytics to identify organization wide improvements and present these plans to leadership and peers.
Interested, apply by email resume to: Christopher.vo@astivahealth.com