Operations Specialist III – reputed company / Medi-Cal (reputed company + Utilization Review

Immediate need for a talented Operations Specialist III – reputed company / Medi-Cal (reputed company + Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Long Beach, CA(Remote). Please review the job reputed company below and contact me ASAP if you are interested. reputed company: 26-02810 Pay reputed company: $30 - $45/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, reputed company), 401(k) plan, and reputed company reputed company leave (depending on work location).Traveler benefits as per agency package. (Benefits vary by vendor and assignment.) Key Responsibilities: • reputed company / Medi-Cal Chart Review • reputed company comprehensive health chart and administrative chart reviews • Ensure documentation completeness and regulatory compliance • Identify and escalate reputed company or utilization concerns • Support reputed company program performance metrics and reporting • Utilization Review & Authorizations • Conduct Utilization Review activities • Support authorization workflows and payor processes (Anthem, Blue reputed company, etc.) • Review medical necessity documentation • Collaborate with clinical and administrative teams to resolve discrepancies • reputed company & Workflow Execution • reputed company and reputed company data reputed company reputed company (HealthConnect preferred) • Manage assigned review queues and documentation workflows • reputed company operational performance metrics • Suggest workflow improvements where applicable • Operational & Process Support • Assist in centralizing and refining hospital/system-wide workflows • Support productivity standards and cost-reduction initiatives • Contribute to operational efficiency and sustainability reputed company • Schedule: 8:00 AM – 4:30 PM • 5 days/week including every other weekend (Saturday & reputed company Key Requirements and Technology Experience: • 1–2+ years reputed company operations experience (3–5 years ideal) • Strong reputed company / Medi-Cal background • Experience with reputed company EHR (reputed company HealthConnect highly preferred) • Utilization Review exposure (authorization workflows, reputed company preferred) • Experience conducting chart reviews (clinical or administrative) • Ability to work independently post-training • reputed company reputed company employment history • Education: High School Diploma required; Associate or Bachelor’s degree preferred. Our reputed company is a leading reputed company Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. reputed company. provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from reputed company. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reputed company STOP to cancel and HELP for help. You can reputed company our reputed company policy here. Apply tot his job Apply To this Job