L.A. Care Health Plan

Seeking a Supervisor, Community Based Care in Los Angeles to lead Community Health Workers (CHW) and optimize care management operations. Requires an RN with an Associate's or an LCSW with a Master's, plus 3+ years of community-based experience and supervisory skills. Key duties include staffing,...

Seeking a detail-oriented **Delegation Oversight Clinical Auditor RN II** in **Los Angeles, CA**. Ensure delegate compliance with **Utilization Management (UM)** regulations and **Medi-Cal** requirements. Requires an **Associate's Degree in Nursing**, an active **California RN license**, and 7+ y...

Seeking a **Care Management Coordinator II** in **Los Angeles, CA** to engage high-need members via telephonic outreach and Health Risk Assessments. Requires a High School Diploma, 6+ months of healthcare admin experience, and medical terminology knowledge. Join a collaborative team to support ca...

Join L.A. Care Health Plan as a Managed Care Pharmacy Resident II in Los Angeles. This advanced residency develops leadership in managed care through formulary design, drug utilization review, and quality improvement. Requires a Bachelor’s in Pharmacy, intern license, and NMS match participation....

Medical Director, Clinical Policy sought in Los Angeles to lead evidence-based policy development and utilization management. This physician leadership role requires an M.D., 8+ years in managed care, and a California license. Oversee clinical architecture, authorization strategy, and regulatory ...

Seeking a Clinical Policy Clinical Coder RN II in Los Angeles to translate medical policies into accurate coding and claims logic. Requires an Associate's Degree in Nursing, 8+ years of clinical experience, and 3+ years in Medi-Cal/Medicare managed care. Key duties include developing codified cla...