Search Public Health jobs

1840 Public Health Jobs

1840 jobs found Jobs found Email me jobs like this
Load More

  • Claims Examiner Sr

    505 City Pkwy W, Orange, California 92868 United States CalOptima Nov 02, 2025
    CalOptima Employer:

    CalOptima

    Our motto and programs “Better. Together.” is our motto, and it means that by working together, we can make things better — for our members and community. As a public agency, CalOptima was founded by the community as a County Organized Health System that offers health insurance programs for low-income children, adults, seniors and people with disabilities. As Orange County’s single largest health insurer, we provide coverage through four major programs:   Medi-Cal California’s Medicaid Program for low-income children, adults, seniors and people with disabilities, offering comprehensive health care coverage   OneCare Connect Cal MediConnect Plan Medicare-Medicaid Plan that combines Medicare and Medi-Cal benefits and adds worldwide emergency care, dental care, vision care and transportation to medical services at no extra cost   OneCare (HMO SNP) Medicare Advantage Special Needs Plan for seniors and people with disabilities who qualify for both Medicare and Medi-Cal   Program of All-Inclusive Care for the Elderly PACE for frail older adults, providing a full range of health and social services so seniors can remain living in the community

    Apply Now View job Employer Profile

    Job Description

    4005021.gif

    Claims Examiner Sr

    CalOptima

    Join Us in this Amazing Opportunity

    The Team You'll Join

    We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

    More About the Opportunity

    We are hoping you will join us as a Claims Examiner Sr and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for analyzing and validating claims elements and claims processing. You will adhere to regulatory and internal guidelines in conjunction with CalOptima Health's policies and procedures related to claims adjudication. You will be responsible for adjudicating more complex claims which require additional research or problem-solving. Together, we are building a stronger, more equitable health system.

    Your Contributions To the Team:
      ◦ 95% - Claims Support
        ◦ Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
        ◦ Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
        ◦ Conducts research and problem solves the more complex claims.
        ◦ Processes professional and institutional claim types.
        ◦ Performs thorough review of pending claims for billing errors and questionable billing practices, including duplicate billing and unbundling of services.
        ◦ Corrects system-generated errors manually prior to final claims adjudication.
        ◦ Processes claims based upon CalOptima Health's contractual agreements or pricing agreements, applicable regulatory legislation, claims processing guidelines and CalOptima Health's policies and procedures.
        ◦ Analyzes and validates Medi-Cal and/or Medicare claims pricing; researches, adjusts and adjudicates claims; reviews services for accurate charges, utilizing billing code sets and/or authorization guidelines as a reference.
        ◦ Processes claim exception reports as assigned.



      ◦ 5% - Completes other projects and duties as assigned.

    Do You Have What the Role Requires?
      ◦ High school diploma or equivalent PLUS 2 years of related claims processing experience required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

    You'll Stand Out More If You Possess the Following:
      ◦ Experience processing online claims in a managed care environment.

      ◦ Experience processing Medi-Cal and/or Medicare claims.


    What the Regulatory Agencies Need You to Possess?
      ◦ N/A

    Your Knowledge & Abilities to Bring to this Role:

      ◦ Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
      ◦ Work independently and exercise sound judgment.
      ◦ Communicate clearly and concisely, both orally and in writing.
      ◦ Work a flexible schedule; available to participate in evening and weekend events.
      ◦ Organize, be analytical, problem-solve and possess project management skills.
      ◦ Work in a fast-paced environment and in an efficient manner.
      ◦ Manage multiple projects and identify opportunities for internal and external collaboration.
      ◦ Motivate and lead multi-program teams and external committees/coalitions.
      ◦ Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

    Your Physical Requirements (With or Without Accommodations):
      ◦ Ability to visually read information from computer screens, forms and other printed materials and information.
      ◦ Ability to speak (enunciate) clearly in conversation and general communication.
      ◦ Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
      ◦ Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
      ◦ Lifting and moving objects, patients and/or equipment 10 to 25 pounds

    Ways We Are Here For You
      ◦ You'll enjoy competitive compensation for this role.
        ◦ Our current hiring range is: Pay Grade: 303 - $51,744 - $72,441 ($24.88 - $34.8274).
          ◦ The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.




      ◦ This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**)
      ◦ A comprehensive benefits package
      ◦ CalPERS pension program and additional retirement packages.
      ◦ Additional benefits and perks including:
        ◦ A generous PTO program
        ◦ A quality work life balance
        ◦ Various wellness programs
        ◦ Tuition Reimbursement
        ◦ Professional development opportunities
        ◦ Career development opportunities
        ◦ Flexible scheduling
        ◦ And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.


    Our Work Environment:

    If located at the 500, 505 Building or a remote work location:
      ◦ Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
      ◦ There are no harmful environmental conditions present for this job.
      ◦ The noise level in this work environment is usually moderate.

    If located at PACE:
      ◦ Work is typically indoors in a clinical setting serving the frail and elderly.
      ◦ There may be harmful or hazardous environmental conditions present for this job.
      ◦ The noise level in this work environment is usually moderate to loud.

    If located in the Community:
      ◦ Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
      ◦ Employee will occasionally work outdoors in varied temperatures.
      ◦ There may be harmful or hazardous environmental conditions present for this job.
      ◦ The noise level in this work environment is usually moderate to loud.

    Why Join Us?

    We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

    What's Your Next Step?

    All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 13, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

    Our Commitment to You

    Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

    If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.

    We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process.

    CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

    CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

    If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.


    To apply, please visit: https://jobs.caloptima.org/jobs/claims-examiner-sr-505-city-parkway-west-california-united-states-55768582-cbb1-4f0a-9b91-f24bd96b3864






    img.php?id=6692130&image=logo
    Copyright 2025 Jobelephant.com Inc. All rights reserved.

    Posted by the FREE value-added recruitment advertising agency



    jeid-1bb2a0ac86e7dd4486ec6272a78643cc
    Apply Now View job Employer Profile

    Please mention you found this employment opportunity on the CareersInGovernment.com job board.

LATEST JOBS

Top Government Public Health Jobs and How to Land Them

Top Government Public Health Jobs and How to Land Them

Public health is a vital and growing field with an extensive range of opportunities to help promote community health and prevent disease. Government public health jobs provide a unique chance to make a lasting impact on society while enjoying job stability and benefits. Here’s everything you need to know about government public health positions and how to land the right job for you.

 

What is Public Health?

Public health is a diverse field that promotes health, prevents diseases, and improves the well-being of populations. Public health professionals work in various environments, including government agencies, non-profits, and private organizations. They focus on disease control, health education, and health service programs. Public health offers many careers, providing fulfilling opportunities to contribute to society.

Key areas of public health include disease control, environmental health, health education, and policy development. These professionals address critical health issues that impact entire communities and play a key role in keeping populations safe and healthy.

 

Benefits of a Career in Public Health

category052-image-001-careers-in-government

Pursuing a career in public health comes with numerous advantages. Working in public health provides job security, competitive salaries, and opportunities for advancement, especially in government public health jobs. It also allows professionals to impact communities meaningfully, work with diverse populations, and address critical health issues like disease control and public health policy.

Many public health careers provide long-lasting and fulfilling opportunities, with the potential to specialize in general health science, clinical services, and disease control. Public health professionals can also grow in their careers by pursuing certifications or advanced degrees that focus on specific health challenges. This growth is often available in government roles at various levels.

 

Top Government Public Health Positions

Government public health positions range from entry-level to executive roles, offering a variety of pathways for advancement. Here are the top positions in government public health:

1. Epidemiologist

Epidemiologists investigate disease outbreaks and implement strategies for disease control. They work with data analysis to track disease patterns and develop prevention plans. Epidemiologists collaborate with public health administrators and health educators to prevent the spread of illnesses.

2. Public Health Administrator

Public health administrators oversee the development and implementation of public health policies. They manage budgets and supervise staff in government health agencies, working closely with epidemiologists and other health professionals to ensure the smooth operation of public health programs.

3. Health Educator

Health educators develop programs to teach communities about health promotion and disease prevention. They implement health campaigns and work closely with other public health professionals to increase public awareness of critical health behaviors.

4. Environmental Health Specialist

Environmental health specialists focus on identifying and mitigating environmental health risks like pollution. They collaborate with the federal government and state health agencies to develop policies to reduce health hazards caused by environmental factors.

5. Health Policy Analyst

Health policy analysts develop and shape public health policies at the federal and state levels. They analyze data, propose new health policies, and work with public and federal employees to implement health initiatives that benefit communities.

 

How to Land a Government Public Health Job

Landing a government public health job can be competitive, but following these steps will increase your chances of success:

category052-image-002-careers-in-government

1. Meet the Basic Qualifications

Most government public health positions require a bachelor’s degree in public health, general health science, or a related field. Some positions may require advanced degrees or certifications in specialized areas like disease control or health service.

2. Build a Strong Resume and Cover Letter

Tailor your resume to highlight relevant experience in public health. Use language from the job description, focusing on key terms like public health positions, federal government, or medical officer roles. Be sure to showcase your public health experience and achievements clearly and concisely.

3. Prepare for the Application Process

Government jobs often require a comprehensive application process, including interviews, background checks, and sometimes extensive documentation. Prepare by practicing interview questions related to public health management and program coordination.

4. Network and Make Connections

Networking can open doors to many public health opportunities. Attend public health conferences, job fairs, and industry events to meet professionals and create connections to help your job search. Online platforms like LinkedIn can also help people connect with others in the field.

5. Stay Persistent

The government hiring process can be lengthy, but persistence pays off. Keep applying for positions at the federal and state levels, and continue building your resume with relevant experience.

Careers In Government
 

Begin Your Career Journey

Launch your career with Careers in Government! Explore exciting opportunities, connect with passionate professionals, and shape your legacy.

JOIN NOW
 

Expanding Your Public Health Career Opportunities

The field of public health offers a wealth of opportunities to grow and specialize. Many public health professionals pursue further education or certifications in specific areas, such as disease control, clinical services, or public health policy, to enhance their skills and open doors to more senior roles. Locations such as South Dakota, New Mexico, and Great Falls offer many opportunities within their government health systems for professionals in public health careers.

The Role of Continuous Education

Continuous education is essential for success in public health. Many professionals pursue certifications or advanced degrees in public health specialties, such as epidemiology, health administration, or environmental health. These credentials can significantly advance your career and open the door to higher-paying and more impactful positions in government or private sectors.

Government public health jobs often require a commitment to learning new skills, especially as public health challenges evolve. Staying informed about advancements in disease prevention and new public health technologies is crucial to remaining competitive.

category052-image-003-careers-in-governmen
 

Opportunities in Specific Government Sectors

Government public health jobs offer the chance to work on large-scale projects that impact entire populations. These roles come with benefits like job security and comprehensive healthcare. Government positions are available at multiple levels:

category052-image-004-careers-in-government
  1. Federal Government Public Health Jobs Federal public health employees work for agencies like the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services. Federal employees help shape national health strategies and work on issues affecting the entire country.
  2. State and Local Government Jobs Public health professionals at the state and local levels focus on implementing programs in their communities. These positions offer the chance to work closely with local populations and address specific public health challenges in states like South Dakota and New Mexico.
  3. Veterans Affairs Public Health Jobs Working for the Department of Veterans Affairs allows public health professionals to contribute to the health and wellness of veterans. These roles can include clinical and administrative positions in cities like Great Falls.
 

Conclusion

Government public health jobs offer diverse and rewarding careers that allow professionals to make a real difference. Whether you’re an epidemiologist, public health administrator, or health educator, the government provides countless opportunities to grow, learn, and contribute to improving public health. By meeting qualifications, building a strong resume, networking, and staying persistent, you can find success in this impactful and fulfilling career path.

Unlock Government Opportunities with Careers in Government

Elevate your career or find the ideal government talent on Careers in Government! Explore and shape the future with us.

JOIN NOW
 
SHOW MORE