Medical Management Coordinator I

AltaMed Health Services; Montebello (CA); On-site; USD 36,000 - 45,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

403(b) Retirement savings plans withem

Flexible Spending Accounts

Paid Time Off & Holidays

Tuition Reimbursement Program

Employee Referral Bonus Program

Job summary

AltaMed Health Services in Montebello, CA is seeking a Medical Management Coordinator I to support medical management operations, focusing on health plan audits, reporting, internal audits, and data validation.

This role collaborates with internal departments and external clients to uphold regulatory compliance, contracts, and DOFR/delegation logic requirements while advancing quality improvement and project management initiatives.

Qualifications

• High school diploma or equivalent required.
• MA or Medical Billing certificate preferred.
• Experience in clinic or health care call center.
• Minimum 2 years in medical billing environment with pre-authorizations and Medi-Cal knowledge.
• Minimum 2 years in healthcare environment with prior authorization and case management regulations.

Responsibilities

• Assist with Health Plan audits, reporting, internal audits, and data validation.
• Coordinate with internal departments and external clients to support operations.
• Apply knowledge of managed care standards and regulatory requirements to projects.

Skills

Quality improvement

Data analysis

Project management

Healthcare call center experience

Education

Medical Billing certificate

MA

Job description

Position Title: Medical Management Coordinator I

Location: Montebello, CA 90640

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.

Remote Type: In Person

About US:

As the nation’s largest Federally Qualified Health Center (FQHC), AltaMed is at the forefront of providing affordable, high-quality health care to underserved communities in Los Angeles and Orange Counties. At AltaMed, you will have the opportunity to work with a diverse team of dedicated professionals who are passionate about making a difference and supporting our community of over 400,000 patients.

Learn About AltaMed: Click Here

AltaMed Health Services Corporation is committed to providing equal employment opportunities for all qualified individuals. We strictly prohibit discrimination in employment based on race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin, age, medical condition, physical or mental disability, military or protected veteran status, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical conditions, genetic information, or any other characteristic protected by local, state, or federal law, ordinance, or regulation.

We are committed to promoting equality and inclusivity beyond our recruitment and hiring processes. We aim to create a respectful, valued, and inclusive workplace through training, advancement opportunities, and access to resources and support. We focus on fostering a diverse workforce because it enriches our organization and improves our ability to effectively serve our clients and community. We encourage individuals from all backgrounds to apply and join us in our mission to create a positive impact.

Equal employment opportunity, including veterans and individuals with disabilities.

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