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As a Grievance and Appeals Coordinator I, you will analyze and resolve claims and authorization appeals, handle verbal and written complaints from members and providers, maintain files on appeals and grievances, and support related functions such as data entry and HEDIS production.

The position involves managing daily operations of provider data management, including overseeing data entry, analysis, and issue resolution, ensuring data quality, leading team workflows, and facilitating meetings with health plan representatives. The role also includes training and mentoring other team members.

The Senior Application Architect is responsible for designing and implementing architectural software systems for Payment Integrity and Accuracy. They lead the vision for services using AWS serverless technologies, ensuring security and scalability, while collaborating with product and engineering teams. The role involves documenting solutions, performing security reviews, mentoring teams, and maintaining high delivery standards for software components.

The Regional Agency Manager is responsible for achieving annual sales goals in the Medicare sector by engaging with local organizations, brokers, and agencies. The role involves addressing escalated issues, providing training, and maintaining strong market knowledge while building internal relationships. Frequent travel within Southern California is required.

As a Regional Agency Manager, you will meet sales goals, engage with local organizations, conduct Medicare training, and build relationships to grow Medicare product lines while responding to escalated account issues. This role requires significant travel within the assigned region.

The Informatica IDMC Administrator II is responsible for administering IT tools and web applications, including configuration, maintenance, troubleshooting, and support. They implement application updates, manage backups, resolve production problems, and develop monitoring processes in collaboration with stakeholders.

The Community Resource Coordinator II connects members to community resources, supports care management journeys, and assists in community outreach. This field-based role involves conducting assessments, providing health education, and supporting the clinical team in facilitating successful community connections.