• Utilization Management Admissions Liaison RN II

    LA Care Health Plan (Los Angeles, CA)
    …Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications ... (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to… more
    LA Care Health Plan (08/02/25)
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  • Account Manager, Delegation Oversight Program

    UCLA Health (Los Angeles, CA)
    …in healthcare operations, highly desired * 5 or more years of experience in health plan operations, compliance , or delegation oversight, required * In-depth ... delegated entities adhere to regulatory standards, contractual obligations, and UCLA Health policies. * Utilize performance data to identify areas for improvement… more
    UCLA Health (07/16/25)
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  • Quality Management Clinical Nurse - Facility Site…

    UCLA Health (Los Angeles, CA)
    …medical appropriateness by using established clinical protocols and health plan resource tools + Assess compliance with healthcare regulations, accreditation ... responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and regulations. This role involves evaluation… more
    UCLA Health (07/14/25)
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  • Director Provider Contracting

    Dignity Health (Bakersfield, CA)
    …Develop agenda and presentation for Contacting Meetings. - Collaborates with Provider Relations, Compliance , and Health Plan Strategy to ensure aligned ... managing performance, and fostering collaborative partnerships with providers and health plan stakeholders. This includes capitation, fee-for-service, and… more
    Dignity Health (07/24/25)
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  • Health Plan Territory Representative…

    LA Care Health Plan (Los Angeles, CA)
    Health Plan Territory Representative II Job Category: Sales & Marketing Department: Product Sales Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... (Mid.) - $82,867.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency...all lines of business. Duties Continued Product Sales Regulatory Compliance : Adheres to compliance of Centers for… more
    LA Care Health Plan (07/06/25)
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  • Manager, Financial Compliance Audit,…

    LA Care Health Plan (Los Angeles, CA)
    …$117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... Manager, Financial Compliance Audit, $10,000 Sign On Bonus Job Category:...County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million… more
    LA Care Health Plan (08/09/25)
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  • Health and Benefits Compliance

    WTW (Los Angeles, CA)
    …will support multiple client projects involving federal health and welfare benefit plan design and strategy compliance issues + You will draft quality client ... this role you will assist in consulting with clients on a wide array of health and welfare compliance issues. You will work closely with experienced … more
    WTW (07/23/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Sacramento, CA)
    …incumbent is responsible for the collaborative and iterative development of the risk and compliance plan for these entities across all areas in the enterprise ... This job is responsible for planning, designing, implementing, and maintaining the Compliance Program and its related policies to ensure the business acts within… more
    Highmark Health (07/29/25)
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  • Specialty Health Plans Auditor III, $5,000…

    LA Care Health Plan (Los Angeles, CA)
    …$88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million...action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors.… more
    LA Care Health Plan (07/06/25)
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  • Pharmacy Compliance Coordinator (Full-Time,…

    Stanford Health Care (Palo Alto, CA)
    Health Care job.** **A Brief Overview** Ensures organizational compliance with federal/state regulations and accreditation requirements (FDA, CDPH, BOP, TJC, ... medication management. Develops audit templates and coordinates/performs required monthly compliance monitoring of enterprise-wide medication storage areas, including investigational… more
    Stanford Health Care (06/17/25)
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