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  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #357
    Tuesday, April 20, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary contact with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly–staffed classification and work is expected to be performed minimally at the MRS II level. However ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #365
    Monday, April 19, 2021
    The Senior Technical Project Manager, under the direction of the Director, Portfolio Management and Service Excellence, is responsible for providing management and support for technical and business project development and implementation throughout Alameda Alliance’s project portfolio. These projects will have technical and/or business components of healthcare operations including claims, membership, utilization and disease management, provider services, finance, compliance, human resources, con ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #356
    Thursday, April 15, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary contact with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly–staffed classification and work is expected to be performed minimally at the MRS II level. However ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #335
    Thursday, April 15, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary contact with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly–staffed classification and work is expected to be performed minimally at the MRS II level. However ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #317
    Wednesday, April 14, 2021
    The Access to Care Manager is intended to work collaboratively throughout the organization to lead and establish appropriate access to care systems.  The Access to Care Manager ensures the access program is in compliance with timely access standards as regulated by the Department of Managed Health Care (DMHC), the Department of Health Care Services (DHCS) and the National Committee for Quality Assurance (NCQA). The Access to Care Manager ensures planning and oversight of access to care surveys, ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #313
    Wednesday, April 14, 2021
    The Clinical Supervisor, Outpatient Utilization Management (UM), under the direction and supervision of the Manager, Outpatient UM, is responsible for monitoring and supervising the daily activities of clinical staff performing prior authorization activities and Out of Plan Services (CBAS, CCS). Works closely with Non-Clinical Supervisor to ensure completion of daily UM activities of staff. Principal responsibilities include:    • Supervise daily activities of staff including distribution ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #349
    Wednesday, April 14, 2021
    The Utilization Management (UM) Coordinator will support clinical staff through completion of the administrative components of Utilization Management (concurrent, urgent and routine pre-service, as well as retrospective authorizations) and Case/Disease management (authorizations, basic care coordination). The Coordinator is responsible for processing and monitoring the authorization process and corresponding documentation continuously for quality and accuracy while working independently within a ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #373
    Wednesday, April 14, 2021
    The Liaison will report directly to the Director of Clinical Initiatives and Leadership Development.  This position serves a key role in the early implementation and refinement of the initiative developed under the umbrella of the department.  This position is a highly interactive and collaborative position that requires continuous dialogue with internal and external partners.The ideal candidate will have an understanding and experience of managed care health plan operations.  Will possess the c ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #344
    Thursday, April 8, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary contact with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly–staffed classification and work is expected to be performed minimally at the MRS II level. However ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #361
    Thursday, April 8, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary interaction with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. MSRs service our members through our call center as well as assisting other departments with responses to member issues by ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #375
    Thursday, April 8, 2021
    The Business Intelligence Analyst is responsible for supporting the analytic needs of the Alliance. This position requires an understanding of healthcare operations and data (e.g. member, claims, clinical and provider data) coupled with experience in programming against complex data environments, quantitative data analysis and analytical tools. The Business Intelligence Analyst, reporting to the Director, Healthcare Analytics, routinely supports business decisions and operational processes and f ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #293
    Wednesday, March 31, 2021
    The Senior Business Intelligence Analyst is responsible for supporting the analytic needs of the Alliance, transforming data into insights to drive business values. This position requires an in-depth understanding of healthcare operations and data (e.g. member, claims, clinical and provider data) coupled with an extensive experience in programming against complex data environments, quantitative data analysis and analytical tools. The Senior Business Intelligence Analyst, reporting to the Direc ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #374
    Tuesday, March 30, 2021
    Under the general guidance from the Supervisor, Data Network Validation, the Provider Network Data Clerk is responsible for providing support to the Provider Services Department. The Provider Network Data Clerk is an entry level position that may be eligible to be flexed into the Provider Data Coordinator I position after completion of 6-12 months to be proficient with program and system knowledge in addition to meeting performance matrix.  Principal responsibilities include:• Process W9 forms ( ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #354
    Friday, March 26, 2021
    The Senior Business Intelligence Analyst is responsible for supporting the analytic needs of the Alliance, transforming data into insights to drive business values. This position requires an in-depth understanding of healthcare operations and data (e.g. member, claims, clinical and provider data) coupled with an extensive experience in programming against complex data environments, quantitative data analysis and analytical tools. The Senior Business Intelligence Analyst, reporting to the Manager ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #363
    Thursday, March 25, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary contact with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorized representative. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly–staffed classification and work is expected to be performed minimally at the MRS II level. However ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #369
    Monday, March 22, 2021
    This position works under the direct supervision of the Manager, Case and Disease Management and is responsible for the operational delivery of the plan’s case management and care coordination programs and processesThe Complex Case Manager Nurse will provide case management services for health plan members with highly complex medical and psychiatric conditions where advocacy and coordination are required to help the member reach the optimum functional level and autonomy.   The Complex Case Manag ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #360
    Monday, March 22, 2021
    Member Services Representatives (MSR) are the first point of contact for our members’ primary interaction with the Alliance for both routine and complex member issues. The MSR provides benefits coordination and customer service for members, and their authorizedrepresentative. This position is a liaison between the plan, the providernetwork, and other community agencies. MSRs service our members through our call center as well as assisting other departments with responses to member issues by in ... More
  • 1240 S Loop Rd, Alameda, CA 94502, USA
    Req #210
    Monday, December 9, 2019
    Medical Coder PRINCIPAL RESPONSIBILITIES:Under the general supervision of the Claims Director, the Medical Coder will accurately review and evaluate coding on member claims for the purpose of reimbursement and researches the use of diagnosis (ICD-10) and procedure (CPT/HCPCS) codes for services provided in accordance with Alliance policies and procedures. In addition, the Medical Coder will provide support to the annual HEDIS audit and review encounter data to resolve coding issues. The Medical ... More