Prospect Medical Systems Web Jobs in Orange

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Prospect Medical is searching for a qualified: EDI Coordinator (Electronic Data Interchange) Responsible for all aspects of Electronic Data Interchange to include Eligibility, Authorizations and Claims. Convert all supplied data via interface programs developed by ProMed HCA. Coordinate with existing EDI Partners and increase participation in the program. Essential Duties include but not limited t...
Prospect Medical is searching for a qualified: Customer Service and Member Relations Manager This position is responsible for operations of the Customer Service Department providing day-to-day oversight of Customer Service Representatives, Member Services Representatives, Transportation and Reception ensuring prompt and timely response and customer satisfaction. As well as the overall management o...
Prospect is looking for an ideal candidate to fill our Physician Contract Administrator * Must have Healthcare/Medical Background * SUMMARY Responsible for sustaining and building assigned network with full panel of Primary Care Physicians and Specialists. Identify network needs and negotiate Memorandums of Understanding (MOUs) and contracts with providers to ensure availability and accessibility...
Prospect Medical is searching for a qualified: Credentialing Coordinator SUMMARY This position performs credentialing and re-credentialing activities according to Prospect Medical Credentialing Policies, contracted health plan policies, CMS, DMHC, and NCQA accreditation guidelines. This position acts as a liaison between our IPAs and contracted health plans. ESSENTIAL DUTIES: include but not limit...
Prospect Medical is searching for a qualified: Manager of Facilities SUMMARY Under minimal supervision, the Manager of Facilities coordinates and directs the design, planning, construction, maintenance, and alteration of equipment, machinery, buildings, and other facilities. The Manager communicates and schedules outside vendor work to accommodate the business needs, while ensuring vendor complian...
Prospect Medical is searching for a qualified: Executive Assistant SUMMARY Provide administrative support to the Chief Executive Officer, and Chief Operating Officers as well as other executive management members.This candidate must be a highly motivated, highly organized, and self-directed individual who can handle a variety of sensitive matters in a professional, mature, and discrete manner. The...
Prospect Medical is searching for a qualified: Customer Service Supervisor This position is responsible for the overall supervision of the day-to-day duties and responsibilities within the Customer Service Department. Individual is responsible for the daily management and oversight of the department schedule and hunt groups to ensure sufficient telephone coverage and compliance of <3% abandonment...
Prospect Medical is searching for a qualified: Pharmacy Technician SUMMARY Prepare and process all referrals. Assist Pharmacists and Case Managers with authorization requests for drugs, diabetic supplies, insulin pumps/supplies, and home infusion. Maintain an atmosphere of professionalism and confidentiality. ESSENTIAL DUTIES AND RESPONSIBILITIES included but not limited to: · Handle stat calls fo...
Prospect Medical is searching for a qualified: Provider Network Manager – O.C. Region SUMMARY JOB SUMMARY: The Provider Network Manager will manage assigned territory at a level to meet all company objectives. Duties and responsibilities will include develop and maintain relationships with assigned physicians, oversee the compliance with identified revenue driven initiatives, and identify, pursue...
Prospect Medical is searching for a qualified: SQL Developer SUMMARY The SQL Developer creates solutions for a variety of business problems. Develops the plan to design solutions, code, and test modifications and enhancements to the existing systems with a high level of reliability and execution speed. Provides assistance to the user community during the implementation of the system or the modifie...
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