- Humana (Sacramento, CA)
- …agents with pre-enrollment inquiries including the following: agent compliance (contracting, licensing, and certification), pre-enrollment inquiries, and agent ... call center. Assist agents with all pre-enrollment inquiries including compliance verification, enrollment, product, and processes. + Utilize documents, websites,… more
- Ventura County (Ventura, CA)
- …or chronic conditions; and facilitating smooth care transitions across the healthcare continuum. The incumbent collaborates with medical directors, providers, and ... members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS), and support wellness, prevention, and...An educational Incentive of 2.5% for completion of an associate 's degree, 3.5% for completion of a bachelor's degree,… more
- Humana (Sacramento, CA)
- …efficiency. Ensure robust database security, backup, recovery, and regulatory compliance in alignment with Humana's standards. Monitor database performance, ... Terraform. Familiarity with cloud security, access management, and regulatory compliance best practices. Excellent communication and documentation skills. Is eager… more
- Danaher Corporation (San Diego, CA)
- …+ Operations (supply chain, manufacturing, EH&S, real estate, etc.) + Compliance and Enablement (QRA/MAPSS, clinical affairs, etc.) + Strategy and Business ... person of influence at the company, serving as one of the legal and compliance team's primary contacts globally; directly partner with and advise leaders of your… more
- Humana (Sacramento, CA)
- …interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and ... medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements,… more
- Humana (Sacramento, CA)
- …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... medical interpretation and determinations whether services provided by other healthcare professionals are concordant with national guidelines, CMS requirements,… more
- Humana (Sacramento, CA)
- …for effective risk management and measurement. Join us in shaping the future of healthcare through AI excellence. We are seeking a Principal Data Scientist to guide ... Our goal is to create safe AI solutions that will revolutionize and improve healthcare experience and outcomes for our customers. Join our rapidly expanding team of… more
- Dignity Health (Bakersfield, CA)
- …ICD-10, HCPCS coding, and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare administration, business, or related field preference ... the detailed and accurate processing, review, and adjudication of complex healthcare claims. This position requires expert knowledge of claims processing, coding,… more
- Abbott (Pleasanton, CA)
- Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of ... healthcare , with leading businesses and products in diagnostics, medical...site's recruitment and data collection performance (enrollment, discrepancy resolution, compliance , etc.). Proactively utilizes appropriate operational metrics to minimize… more
- Grifols Shared Services North America, Inc (San Diego, CA)
- Would you like to join an international team working to improve the future of healthcare ? Do you want to enhance the lives of millions of people? Grifols is a global ... healthcare company that since 1909 has been working to...Other duties include responsibility for safety, regulatory and/or environmental compliance ; ensuring continuous improvement of processes; and using expertise… more