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The following jobs are available the week of: January 05, 2009 Thru January 11, 2009
Simply click on a job title to jump to a summary of the job description, experience required and salary range.
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| Accountant | Claims Internal Auditor |
| Contracts Manager | Enrollment Advisor |
| Health Education Associate | Network Administrator |
| Provider Services Coordinator | Provider Services Representative |
| UM Coordinator | UM Nurse |
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Please FAX or E-Mail your resume indicating the position you are interested in to: |
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Inland Empire Health Plan ATTN: Human Resources Department Fax: (909) 890-2929 E-Mail: Human_Resources@iehp.org |
| ACCOUNTANT | |
| Experience: | |
| Bachelor's degree required in Accounting/Finance. Three (3) years experience, knowledge or database, spreadsheet and general ledger programs, claims experience preferred. | |
| Knowledge/Skills: | |
| Responsible for month-end journal entries and workpapers, budget to actual variance reports, general ledger account analysis, departmental financial statements preparation and detailed analysis of trends. | |
| Salary: $42,250 - $60,000 | |
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| CLAIMS INTERNAL AUDITOR | |
| Experience: | |
| Possession of a bachelor's degree preferred. Four (4) years claims processing experience. Two (2) years experience auditing claims in a managed care environment. Experienced in contract and financial DOFR interpretation. | |
| Knowledge/Skills: | |
| Responsible for the internal auditing of IEHP's claims payment system and processes and the research and recovery of claims overpayments. Solid understanding of DMHC, DHCS, CMS, and MRMIB regulations for claims adjudication practices. | |
| Salary: $38,250 - $54,000 | |
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| CONTRACTS MANAGER | |
| Experience: | |
| Possession of a Bachelor's degree. Minimum of four (4) years experience in a managed care environment. A valid California Drivers License required. | |
| Knowledge/Skills: | |
| A minimum of three (3) years of direct experience in negotiating and analyzing Physician, Hospital and Ancillary contracts preferred. Analytical skills with emphasis on time management, financial analysis, and problem solving. Microcomputer applications for use in all aspects of an office environment. Thorough knowledge of contracting structures and payment methodologies preferred. Excellent communication, interpersonal and organizational skills. | |
| Salary: TBD | |
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| ENROLLMENT ADVISOR | |
| Experience: | |
| High School diploma or equivalent required. Possession of a valid California Drivers license and valid automobile insurance. | |
| Knowledge/Skills: | |
| Bi-lingual Spanish required. Must be fluent conversationally and in writing. Testing will be required to determine bi-lingual language level. Excellent PC skills with emphasis on data entry, spreadsheet, word-processing (candidates will be tested for proficiency level in data entry and word processing). Must have excellent verbal communication skills, positive interpersonal skills, sensitivity to a multi-cultural environment, superior time management and organization habits. Knowledge of the Healthy Families Program, Medi-Cal or Managed Care Health Care Benefits desired, but not required. | |
| Salary: $29,172 - $41,185 | |
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| HEALTH EDUCATION ASSOCIATE | |
| Experience: | |
| Minimum of a Bachelor's degree in community or public education, or a related field. Two (2) or more years of experience in a health education program, preferably in a managed care setting. | |
| Knowledge/Skills: | |
| English/Spanish bilingual capabilities, at speaking, reading and translation levels preferred, and may be required for selected Health Education Associate positions that oversees the cultural and linguistic program. Possession of a valid State of California driver's license | |
| Salary: TBD | |
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| NETWORK ADMINISTRATOR | |
| Experience: | |
| Graduation from an accredited four-year college with a major in computer science, mathematics, accounting, public or business administration, or healthcare. For non-degreed candidates, two years of applicable experience may be substituted for a year of college. The following experience may be concurrent: Over 5 years experience in Network administration. 3 years Systems Administration. | |
| Knowledge/Skills: | |
| Extensive knowledge of multiprotocol systems and implementation experience with multi-vendor network systems. Techniques of systems analysis, design, and implementation, including principles and practices of project control, physical and logical security techniques, Microsoft 2003 Systems Administration, operating systems and administration, and client/server principles and techniques. | |
| Salary: $53,760 - $75,900 | |
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| PROVIDER SERVICES COORDINATOR | |
| Experience: | |
| Possession of a high school diploma or equivalent; Two (2) years knowledge of medical groups and HMO or IPA operations, preferably in a managed care setting. | |
| Knowledge/Skills: | |
| This position will transition into the Provider Call Center currently in development. Excellent communication and interpersonal skills, understanding of and sensitivity to multi-cultural community, strong organizational skills, typing 45 words per minute, proficient in MS office applications, telephone courtesy, high degree of patience, experienced in data entry, knowledge of Medi-Cal/managed care environment. | |
| Salary: $29,172 - $41,185 | |
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| PROVIDER SERVICES REPRESENTATIVE | |
| Experience: | |
| Possession of a Bachelor's degree required. Valid California Driver's license required. A minimum of three or more years direct experience with Managed Care, working knowledge of Medical Group/IPA and HMO operations. Three or more years experience with customer service. | |
| Knowledge/Skills: | |
| Provider Services Representative is responsible for anticipating, recording and responding to Provider needs, to represent IEHP in a friendly and professional manner. Communicate regularly through Joint Operations Meetings. Act as a Provider Advocate. Strong organization skills, excellent written and verbal communication and interpersonal skills. Microcomputer applications (Microsoft Word and Excel, Access preferred) for use in all aspects of an office environment. | |
| Salary: $38,250 - $54,000 | |
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| UM COORDINATOR | |
| Experience: | |
| Possession of a high school diploma or equivalent. Two (2) years customer service experience, preferably in an HMO or Managed Care setting. Knowledge of computer applications, including word processing, database and spreadsheets. Requires knowledge of ICD-9 and CPT codes. | |
| Knowledge/Skills: | |
| The UM Coordinator is responsible for the timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses. The UM Coordinator will also ensure that provider calls are responded to in an accurate and timely manner. Responsible for monitoring the Right Fax Server. | |
| Salary: $29,172 - $41,185 | |
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| UM NURSE | |
| Experience: | |
| Possession of a valid RN or LVN license issued by the Sate of California. Possesssion of a valid State of California Driver's license. Experience in-patient/out-patient UM concurrent review. | |
| Knowledge/Skills: | |
| Two (2) years or more case management in managed care setting or related experience in a health care delivery setting. Experience in an HMO or experience in Managed Care setting preferred. | |
| Salary: TBD | |
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