- Humana (Sacramento, CA)
- …relationships with corporate and market teams, including IT, Quality Operations and Compliance , and Risk Adjustment, as well as vended partners. The Senior HEDIS ... Operations & Quality Professional supports all aspects of the non-standard supplemental (NSS)...scenarios, and opportunities for improved member health and measure compliance + Internal and external partnerships to coordinate, guide,… more
- Prime Healthcare (Inglewood, CA)
- …of departmental goals, policies, and performance improvement initiatives. + Ensure compliance with all applicable federal, state, and regulatory standards. + Oversee ... adjustments to care plans when appropriate. + Support a professional practice environment that encourages growth, accountability, and teamwork. Qualifications… more
- Prime Healthcare (Inglewood, CA)
- …core values of quality, compassion, and community. As a member of Prime Healthcare , a Top-15 hospital system in the United States, Centinela Hospital Medical Center ... and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor… more
- Roche (Santa Clara, CA)
- …aim to prevent, stop and cure diseases and ensure everyone has access to healthcare today and for generations to come. Join Roche, where every voice matters. **The ... a vital role in shaping and enhancing SHE programs that support compliance , sustainability, and operational excellence. If you're passionate about driving change and… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …Directs activities of Clinicians and Activities Therapists. This includes ensuring compliance with all treatment plan requirements including weekly review and ... completed). Oversees maintenance of patient clinical records and reports to ensure compliance with local, state and federal laws. Advises, and counseling when… more
- CenterWell (Sacramento, CA)
- …data extraction and analysis using query tools and reporting platforms. + Ensure compliance with healthcare regulations and internal standards. + Contribute to ... community and help us put health first** The Senior Business Systems Analysis Professional plays a critical role in supporting the delivery and optimization of… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are ... expenditures for an organization that provides health insurance. The Subrogation Professional 2 work assignments are varied and frequently require interpretation and… more
- CenterWell (Sacramento, CA)
- …an in-depth evaluation of variable factors. The Senior Pharmacy Contracting Professional ensures contract compliance and performs analysis regarding pharmacy ... and help us put health first** The Senior Pharmacy Contracting Professional conducts all aspects of pharmaceutical contracting and pricing including development,… more
- Alameda Health System (Oakland, CA)
- Supervisor, Hospital and Professional Fee Coding + Oakland, CA + Information Systems + Health Information Servcies + Full Time - Day + Management + $41.42 - $69.04 / ... for accuracy of data in the abstract to ensure compliance with regulatory agencies and AHS procedures. **DUTIES &...reimbursement assignments. 6. Assists the Coding Manager and attends professional meetings as needed. 7. Training coding staff as… more
- Humana (Sacramento, CA)
- …community and help us put health first** The Senior Acquisition Implementation Professional manages all aspects of Medicaid State Implementations, from start to ... it is completed on time and within budget. The Senior Acquisition Implementation Professional works on problems of diverse scope and complexity ranging from moderate… more