Immediate opening to work in Los Angeles and Orange County area with a fast growing company in the healthcare industry to expand its physician network.

Must have at least one year experience in managed care or health care field with familiarity in working with physicians. Should be able to market current contracts to prospective providers of all types, evaluate adequacy of primary care physician, specialty and ancillary networks to identify needs and opportunities for expansion within assigned market. Excellent verbal communication skills are required.

Please send resume to: Maggie@pcacipa.com or fax to 310-835-6520.

Program Coordinator

The Program Coordinator will serve as the point of contact for patient related issues and as the liaison between patient and providers. This full time position requires the ability to effectively manage multiple projects, and communicate effectively with providers and patients. Ideal candidate will have strong computer skills in Microsoft Office (Excel, Word, Access), ability to perform minor data analysis, medical terminology, along with the ability to complete tasks in a timely manner. Minimum 2 years healthcare experience and Bachelor’s degree required. Qualified candidates should send resumes in confidence to: resumes@coasthealthcare.net

Care Coordinator

The Care Coordinator is responsible for providing support to the Case Management team to prevent and reduce readmissions by ensuring that patients are supported in the transition from an inpatient to outpatient setting. The coordinator will assist the Case Managers regarding discharge planning and post hospital follow-up care. This full time position requires 2 or more years of healthcare experience and post high school education or associate degree. Graduate from Medical Assistant program is highly preferred. Strong problem solving skills, customer service oriented, excellent telephone etiquette and organize and detail-oriented. Qualified candidates should send resumes in confidence to: resumes@coasthealthcare.net

Case Manager

Seeking a motivated, compassionate Case Manager RN or LVN with recent managed care or acute care experience in case/care management. This individual should have excellent communication skills, both written and verbal, experience in the assessment, planning, intervention, and coordination of care for those members at highest risk for health decline and increased utilization of inpatient resources. This person would need to be able to coordinate members care across care settings, assisting members to navigate through the healthcare delivery system, ensuring the needs of the members are met, promoting health while controlling costs. Qualified candidates should send resumes in confidence to: resumes@coasthealthcare.net

Customer Services Coordinator

Seeking a customer services coordinator to provide information and clarification on claims, authorization, eligibility and provider information. Able to handle high volume of calls, detailed oriented, multi task, able to navigate through computer applications, excellent communication skills, reliable, team player. Experience in a medical office, IPA, MSO, medical billing company or Health Plan is a must and Spanish speaking a plus. Qualified candidates should send resumes in confidence to: resumes@coasthealthcare.net
 

Utilization Review Nurse

Seeking a LVN/RN with strong clinical and interpersonal skills to review the authorization requests for medical appropriateness and correct vendors. Responsibilities include Liaison with designated Medical Director for complex authorization requests. Functions as clinical resource for benefit interpretation. Researches complicated cases. Screens for CCS diagnosis and refers appropriately, CA License, RN or LVN. Minimum of 3 years case management, utilization or discharge planning experience in an IPA, Medical Group, Hospital or Health Plan environment with knowledge of Milliman or Interqual Guidelines and computer literate. Spanish speaking is required.