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Remote Prominence Health Plan Jobs in California

Community Health System

Sr. Auditor, Health Plan

Fresno, CA · On-site +1

$46.52 - $59.20/hr

Overview Remote or Onsite Opportunity! Opportunities for you! * Consecutively recognized as a top ... California Health Plan experience preferred * Experience working with QNXT is a plus. Licenses and ...

Community Health System

Sr. Auditor, Health Plan

Fresno, CA · On-site +1

$46.52 - $59.20/hr

Remote or Onsite Opportunity! Opportunities for you! * Consecutively recognized as a top employer ... California Health Plan experience preferred * Experience working with QNXT is a plus. Licenses and ...

Community Health System

Sr. Auditor, Health Plan

Fresno, CA · On-site +1

$80K - $98K/yr

Overview Remote or Onsite Opportunity! Opportunities for you! * Consecutively recognized as a top ... California Health Plan experience preferred * Experience working with QNXT is a plus. Licenses and ...

Molina Healthcare

COO, Health Plan (Ohio)

Long Beach, CA · Remote

$214K - $417K/yr

... health plan. Responsibilities include: implementing programs that are in alignment with Molina ... and Remote Office leadership and guidance. Preferred Work Location - Ohio Knowledge/Skills ...

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Remote Prominence Health Plan information

What is the difference between Remote Prominence Health Plan vs Remote Medical Coder?

AspectRemote Prominence Health PlanRemote Medical Coder
Required CredentialsHealth insurance knowledge, possibly certifications like CPC or CCSCertification in coding (CPC, CCS), medical terminology knowledge
Work EnvironmentRemote, healthcare insurance settingRemote, healthcare documentation and billing
Employer & IndustryHealth insurance providers, managed care organizationsHospitals, clinics, billing companies
Common Search/ComparisonInsurance plan roles, healthcare benefitsMedical coding jobs, billing specialists

Remote Prominence Health Plan typically involves managing insurance plans, benefits, and member services, requiring knowledge of healthcare policies. Remote Medical Coders focus on translating medical records into codes for billing, requiring coding certifications. Both roles are remote healthcare positions but differ in daily tasks and required credentials.

What is a remote Prominence Health Plan?

A Remote Prominence Health Plan job typically refers to a position with Prominence Health Plan that allows employees to work from home or another remote location, rather than in a traditional office setting. These roles can vary widely and may include positions in customer service, claims processing, care coordination, or other administrative functions within the health insurance sector. Working remotely for Prominence Health Plan typically requires reliable internet access, a suitable workspace, and proficiency with digital communication tools. Employees benefit from flexible work arrangements while supporting the delivery of healthcare services and insurance solutions to members.

What are some common challenges faced by professionals working remotely for Prominence Health Plan, and how can they be successfully managed?

Working remotely for Prominence Health Plan often involves collaborating with cross-functional teams across different time zones, which can make communication and scheduling a challenge. Staying organized and proactive in communication—such as utilizing project management tools and regularly participating in virtual meetings—can help address these hurdles. Additionally, remote employees may need to adapt to evolving healthcare regulations and maintain strict data security practices. Building a strong rapport with team members and seeking ongoing feedback can also enhance productivity and job satisfaction in a remote setting.

What are the key skills and qualifications needed to thrive as a remote Prominence Health Plan specialist, and why are they important?

To thrive as a Remote Health Plan Specialist, you need a solid understanding of healthcare insurance policies, benefits administration, and regulatory compliance, typically requiring experience in health insurance or related certifications. Familiarity with CRM software, claims processing systems, and telehealth platforms is important for managing member inquiries and documentation remotely. Excellent communication, attention to detail, and problem-solving skills are crucial for effectively assisting members and resolving complex issues. These competencies ensure accurate service delivery, member satisfaction, and compliance with industry standards in a remote work environment.
What are the most commonly searched types of Prominence Health Plan jobs in California? The most popular types of Prominence Health Plan jobs in California are:
What cities in California are hiring for Remote Prominence Health Plan jobs? Cities in California with the most Remote Prominence Health Plan job openings:
Remote Prominence Health Plan jobs near you

Sr. Auditor, Health Plan

Community Health System

Fresno, CA • On-site, Remote

$46.52 - $59.20/hr

Full-time

Re-posted 19 hours ago

Job description

Overview

Remote or Onsite Opportunity!

Opportunities for you!

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek
  • Free Continuing Education and certification
  • Tuition reimbursement, education programs and scholarships
  • Vacation time starts building on Day 1, and builds with your seniority
  • Free money toward retirement with a 403(b) and matching contributions
  • Great food options with on-demand ordering
  • Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.


Responsibilities

The Senior Auditor oversees and performs financial, operational, and technology audits and other special projects designed to add value and reduce risk to the strategies and objectives of Community Care Health (CCH). Designs and prepares audit programs, conducts fieldwork, prepares work papers, drafts reports, and follows up on management corrective actions in accordance with professional auditing standards. Reviews workpapers, reports, and other documentation prepared by staff, peers, and others.

Qualifications

Education
  • Bachelor's Degree in Accounting, Business, Management, Finance, Healthcare Administration, Information Systems/Computer Science, Nursing, or related field required
  • Master's Degree Business, Healthcare, or related field preferred
Experience
  • 3 years of audit or related experience required
  • Healthcare background, revenue cycle, cost reporting, claims, provider data, health plan, or clinical experience preferred
  • Experience in data analytics (e.g., ACL, SQL) preferred
  • Experience with root cause analysis
  • California Health Plan experience preferred
  • Experience working with QNXT is a plus.
Licenses and Certifications
  • One of the following is required within 1 year of hire or transfer into position:
    • CHIAP - Certified Healthcare Internal Audit Professional
    • CIA - Certified Internal Auditor
    • CISA - Certified Information Systems Auditor
    • CPA - Certified Public Accountant License
    • CHS Approved Audit-Related Certification