Dignity Health Management Services

The LVN Coordinator performs patient care management services supporting the established plan of care, which includes relaying physician instructions, collecting patient data, and documenting concerns within the operational platform. This role also involves conducting telephonic screenings, referring patients to appropriate programs or specialists, and providing leadership support to staff.

The Credentialing Specialist manages all credentialing activities for IPAs and product lines, handling daily operations including resolving non-responsive providers and ensuring compliance with NCQA and health plan standards through collaboration with various internal and external stakeholders. Responsibilities also include coordinating with the Credentials Verification Organization (CVO) for initial and recredentialing processes, monitoring CVO performance, and managing application reviews and fee reconciliation.

The Enrollment Technician coordinates and oversees the membership enrollment process, reconciling membership data against capitation payments and resolving enrollment issues for various health plans. Responsibilities include processing enrollment and eligibility files, acting as a primary contact for health plans, and maintaining high levels of data integrity within the database.

As the Manager, Clinical Quality Improvement, you will lead a team of dedicated LVNs/RNs in support of organizational quality improvement initiatives across Medicare, Medicaid and Commercial space. You will partner with other departments, health plans and providers to develop and...

As the Supervisor, Continuing Care, you will manage daily operations for the assigned department(s), focusing on: Clinical resource management Transitions of care across the continuum Patient advocacy Best practice in medical and social necessity determination You will be respons...

As our Program Manager, you will lead the project development life cycles for key strategic ambulatory/population health quality initiatives, bridging strategy with execution under the direction of assigned senior leader(s). Work closely with leadership, serving as a Business Spo...

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. This role involves making direct decis...

The Contract Specialist II, reporting to the Network Operations/Contracting Manager, plays a critical role in managing contracts within the PHSO. This position demands a strong grasp of healthcare regulations and contract law to develop, negotiate, and oversee a variety of agreem...