Medical Management Coordinator I

Job description

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview The Medical Management Coordinator I serves under the direction of the Supervisor of Medical Management Operations. Responsible for preparation efforts in key areas of focus, including Health Plan audits and reporting, internal audits, and data validation. This position is essential to maintaining an effective and efficient working relationship with all internal departments and external clients. Collaborates with staff dedicated to the execution of operational functions to maintain and support the strategic objectives of the managed care medical management division. Incumbent should possess knowledge of managed care industry standards, familiarity with government regulations, experience in interpreting full-service health plan contractual DOFR and delegation logic requirements, understanding of regulatory compliance, and experience in working on collaborative projects. Minimum Requirements High School Diploma or equivalent required. MA or Medical Billing certificate preferred. Prior experience working in a clinic or health care call center. Minimum 2 years of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations on Medi-Cal, CCS, and other government programs required. Minimum 2 years’ experience working in a healthcare environment; knowledge of prior authorization and case management regulations governing Medi-Cal, Commercial, Medicare, CCS, and other government and commercial programs. Minimum 2 years of experience in quality improvement/data analysis/project management with successful deployment demonstrating measurable positive results. Compensation $26.91 - $33.53 hourly Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.