Hybrid; Los Angeles | 橙縣
IT Analyst (System Administrator)
A system administrator, or sysadmin, is a person who is responsible for the upkeep, configuration, and reliable operation of computer systems and the technology infrastructure.
福全健保的成立宗旨是協助社區成員瞭解其醫療保健事務的複雜性。我們致力根據文化差異，以會員所通曉的語言為其提供更優質的醫療保健解決方案服務。我們提供的計劃融合了東西方醫學的優點，實現對會員健康和福利的承諾。
Clever Care offers our associates medical, dental and vision plans, as well as Health Care and Dependent Care reimbursement accounts, life insurance, disability, and accident coverage.
Our competitive 401(k) plan includes a generous company match and vesting schedule.
Full time employees are eligible for paid vacation days and sick leave hours. Clever Care observes ten paid holidays per year.
We are looking for people that are as excited as we are to help build a platform that empowers our members and connects Eastern and Western medicine to provide comprehensive health solutions.
A system administrator, or sysadmin, is a person who is responsible for the upkeep, configuration, and reliable operation of computer systems and the technology infrastructure.
This position is responsible for maintaining and supporting the Medicare formulary and providing clinical and economic data necessary to make formulary decisions.
The Special Needs Plan (SNP) Program Case Manager provides a holistic care model which involves collaboration with members and their families, caregivers, and providers.
We are looking for creative analysts with a passion for healthcare to support our mission to improve the lives of our members. Qualified candidates will be interacting closely with data team members and business stakeholders across various business domains.
As a Data Analyst at Clever Care Health Plan, you will be part of a fast-paced, knowledgeable and energetic Data and Analytics team that continuously adapts and expands our data ecosystem.
The Provider Dispute Resolution and Appeals Specialist (“Specialist”) is responsible for processing provider appeals and disputes accurately and timely.
Responsible for assisting in creating and maintaining corporate approved letters using Napersoft, Word, and SQL.
Under the direct supervision of the Regional Sales Manager, the Supervisor of Sales Operations is responsible for providing all aspects of operational support to the sales organization’s various distribution channels, which includes but is not limited to material distribution management, training, sales systems support, issue resolution, sales performance tracking and reporting, tools development, give-away ordering, and policy and procedure development and monitoring.
We are looking for a Field Engagement Specialist (Coordinator) who wants to make a difference in the community. The ideal candidate will be motivated by Clever Care’s mission to deliver culturally-sensitive health care solutions to seniors in our community and connect our offerings with community groups with similar missions. Candidate must be dynamic and have strong interpersonal skills.
The Product Implementation Manager position is responsible for multiple Medicare operational process and functions, including bid submission and implementation of products to downstream systems and vendors with a focus on quality assurance, ensuring end‐to‐end that what we implement is consistent with our product filings.
Supports the Provider Relations Field Representative to achieve department goals. Responds to customer service and provider relations inquiries from providers and assist with problem resolution of issues. Coordinate’s provider submissions to internal departments via required forms.
The ACO is responsible for overall company’s compliance to federal and state regulations (e.g., CMS, CA DMHC, DOI). The ACO will collaborate and support sales/brokers, providers/vendors, FDR (First-tier, Downstream, Related entities), finance, IT and operations teams to successfully pass regulatory audits.
Sales Operations Administrative Assistant/Coordinator will assist the Sales Operations team with ongoing daily job responsibilities to manage key action items, special project activities/initiatives, and deadlines.
works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential.
The Medicare Enrollment Supervisor serves as a proxy for the Manager of Enrollment and Reconciliation, overseeing the activities and personnel of the Enrollment department while ensuring its processes operate smoothly.
Under the direction of the Claims Manager, the Claims Examiner III reviews and adjudicates complex or specialty claims, submitted either via paper or electronically.
The Agency Account Executive is responsible for helping the regional teams to achieve Clever Care’s established Medicare enrollment objectives in their assigned language segments, by working with the Regional Managers and Field Agency Leaders to drive enrollments through contracted Agencies and Agents.
Responsible for creating and maintaining eligibility records and addressing any concerns related to member enrollment.
Member Advocates are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors.
The consultant will educate prospective members on Clever Care products and enroll into product of choice over the phone or other sales enrollment channels.
This role supports day-to-day network development activities including managing key action items, special project initiatives, and deadlines.
H7607_21_CM0028A_EN_M Accepted 09292020
福全健保是一項與聯邦醫療保險簽有合約的 HMO 計劃。投保福全健保需視續約情況而定。
10 月 1 日至 3 月 31 日：
每天上午 8 時至晚上 8 時（週末無休）
4 月 1 日至 9 月 30 日：
週一至週五上午 8 時至晚上 8 時
© 2021 保留所有權利。CLEVER CARE OF GOLDEN STATE, INC. 係 Clever Care Health Plan Inc. （福全健保）獨資子公司。
