Prospect Medical Systems Jobs & Careers

53 jobs

Prospect Medical Systems
Prospect Medical is searching for a qualified: Manager of Compliance SUMMARY This position has responsibility to coordinate the development, maintenance, implementation and revisions of policies and procedures and other documents for the UM/CM/QM operation of the Medical Management Department. Position manages and ensures the department is in compliance with all federal, state, and local laws.(...

Prospect Medical Holdings
Vice President, Talent Management Prospect Medical Holdings Home Base: Greater Los Angeles Area Scope: National WHO WE ARE: Prospect’s Mission Statement: “We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Benefit Configuration Specialist (Health Plan Benefits/DOFR) SUMMARY Under minimal supervision, this position is responsible for creating, updating and maintaining vendor contracts, fee schedules, reading and interpreting contracts and/or contract summaries, and assigning fee schedules to providers. Responsible for creating, updating and maintainin...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Vice President of Provider Network Management for Los Angeles County Location: Los Angeles County or Orange County SUMMARY Responsible for achieving an operating budget, quality benchmarks, membership targets and physician development goals, while ensuring quality and satisfying service to members, physicians and provider partners. Develops and im...

Prospect Medical Systems
Prospect Medical is searching for a qualified: HEDIS/P4P Specialist SUMMARY Coordination of P4P Self Reporting Audit, roadmap preparation, data collection and reporting processes in addition to HEDIS intervention activities to improve related clinical performance measures for the commercial and Medi-Cal lines of business. Additionally, this position will take a lead role in coordinating the eff...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Sr. Business Solutions Project Manager SUMMARY We are seeking an accomplished and seasoned Senior Business Solutions Project Manager (BSPM) that is capable of being responsible for the overall delivery of medium to large scale technical projects to assist the business in meeting its financial, strategic and regulatory goals. ESSENTIAL DUTIES inclu...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Business Development Manager SUMMARY The position of the Business Development Manager ensures growth of new members and retention of existing members within our Alta Hospital Systems Network. This position is integral in representing our IPA's and Alta Hospital System to our providers as well as employers and community. Responsible for developing a...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Medical Assistant – Front Office SUMMARY This PART TIME position is the first point where contact is made personally or by telephone. The person will receive the patient and direct them to the services needed. Making appointments and making preliminary assessment category of payment for patients are essential before provider can see them. ESSENTIA...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Post Discharge Coordinator SUMMARY Daily telephonic Post-Discharge calls to all members within 24 – 48 hours after discharge from Acute Setting and Skilled Nursing Facilities. Ensure member receives an outpatient appointment and conducts follow-up with patient or caregiver. ESSENTIAL DUTIES include, but are not limited to: Calls to members are co...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Quality Care Coordinator SUMMARY This position is responsible for assisting to ensure the highest percentage of compliance is achieved in meeting our P4P yearly goals. Individual will run target reports from Ascender (or similar platform) and organize the Patients Due reports in preparation for contact to schedule or educate the members. Individual...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Customer Service Supervisor SUMMARY 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% a...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Referral Coordinator SUMMARY Prepares all referrals and coordinates them for review or denial. Assist the Referral Nurse and Medical Directors daily with additional information needed or benefit verification. Responsible for maintaining stat line. Documents pertinent information in Cerecons and IDX referral system. ESSENTIAL DUTIES AND RESPONSIBIL...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Case Manager Summary Performs care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health n...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Patient Care Coordinator SUMMARY Prepares all referrals and coordinates them for review or denial. Assist the Referral Nurse and Medical Directors daily with additional information needed or benefit verification. Responsible for maintaining stat line. Documents pertinent information in Cerecons and IDX referral system. (please note - this is curre...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Network Manager – Los Angeles Region SUMMARY The 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 and grow new membersh...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Network Manager – Los Angeles Region SUMMARY The 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 and grow new membersh...

Prospect Medical Systems
Prospect is looking for the ideal candidate to fill our Case Manager or Inpatient Concurrent Review Nurse As Inpatient Concurrent Review Nurse, · You are responsible for coordination of daily inpatient services and discharge planning function in accordance with Prospect Medical Group policies, procedure and processes. · Interacts with the Medical Directors and hospitalists on a daily basis to ...

Nix Healthcare
Vice President, Human Resources (Nix Healthcare) Prospect Texas Region Location: San Antonio, TX WHO WE ARE: Prospect’s Mission Statement: “We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, pe...

Prospect Medical Systems
Prospect Medical is searching for a qualified: Personal Care Coordinator SUMMARY This position of Personal Care Coordinator (PCC) will serve as a liaison between OneCare members, the Prospect Medical Group, CalOptima, medical providers, behavioral health providers and Long Term Support Service (LTSS) providers. The PCC will identify and reduce barriers to members’ care, assist the member in loc...

Prospect Medical Holdings
Vice President, Internal Audit Prospect Medical Holdings WHO WE ARE: Prospect’s Mission Statement: “We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live health...