• Process Improvement Lead , Healthcare…

    Humana (Sacramento, CA)
    …to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, mission-driven ... help us put health first** As a Process Improvement Lead , you'll play a key role in analyzing and...+ 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing , system… more
    Humana (08/29/25)
    - Related Jobs
  • Claims Research Specialist

    Dignity Health (Bakersfield, CA)
    …procedures. - Monitor and respond to regulatory changes that impact claims processing and research activities. - Schedule and lead meetings with all affected ... all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration,...the organization to ensure customer resolution is complete - Lead investigations into claims overpayments, underpayments, and… more
    Dignity Health (08/28/25)
    - Related Jobs
  • Sr. Corporate Claims Specialist

    Golden State Foods (Irvine, CA)
    …and oversees claims handling procedures and program enhancements to streamline claims processing and mitigate loss + Manage quarterly claim review with ... or university. + 5-7+ years of progressive experience as an Insurance Claims Adjustor, TPA Team Lead , or Corporate Risk Manager with a high acuity for workers… more
    Golden State Foods (06/07/25)
    - Related Jobs
  • Lead Data Tech / Processing Tech

    BrightSpring Health Services (Union City, CA)
    …Prior supervisory experience. Skills/Knowledge: + Required: Knowledge of Medicaid claims regulations and processes. Basic understanding of drugs, medication ... Identifies and resolves issues of denials or follow-up of claims . + Maintains current knowledge of Medicaid claim regulations...+ Produces reports and keeps management informed of unpaid claims and claims pending follow-up. + Understands… more
    BrightSpring Health Services (07/17/25)
    - Related Jobs
  • Payment Integrity Program Manager - Health Plan…

    Molina Healthcare (San Diego, CA)
    …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
    Molina Healthcare (08/08/25)
    - Related Jobs
  • Lead Prior Authorization Specialist

    Polaris Pharmacy Services, LLC (Covina, CA)
    Lead Prior Authorization Specialist Job Details Job Location Polaris Specialty Pharmacy LLC - Covina, CA Salary Range $28.00 - $29.00 Hourly Job Category ... for career advancement to all our team members. JOB SUMMARY: The Lead Prior Authorization Specialist is responsible for managing and identifying a portfolio… more
    Polaris Pharmacy Services, LLC (08/23/25)
    - Related Jobs
  • Senior Director, ADHD Brand Lead

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    …visible leadership position has been designed for an executive marketing professional to lead the US Centanafidine launch, a novel treatment for ADHD. The compound ... launch that results in significant contribution to overall brand growth and lead commercial team members responsible for creating and implementing brand strategy… more
    Otsuka America Pharmaceutical Inc. (08/26/25)
    - Related Jobs
  • Lead Data Scientist - Research…

    Highmark Health (Sacramento, CA)
    …progressions, and treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development, specializing in Graph Intelligence, ... insights in healthcare. This is a premier R&D position where you will lead the charge in inventing and proving out transformative graph-native analytical solutions.… more
    Highmark Health (08/29/25)
    - Related Jobs
  • Medicaid Lead , Technology Solutions

    Humana (Sacramento, CA)
    …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... of our caring community and help us put health first** The Medicaid Lead , Technology Solutions builds strategic partnerships and manages relationships between IT and… more
    Humana (08/26/25)
    - Related Jobs
  • QA Technician ( Lead )

    Astrix Technology (San Bernardino, CA)
    **QA Technician ( Lead )** Laboratory San Bernardino County, CA, US Pay Rate Low: 20 | Pay Rate High: 23 + Added - 12/08/2025 Apply for Job We are seeking a **Quality ... and warehouse areas. + Collect and log production and processing samples. + Ensure non-conforming products are placed on...including FDA, COOL, Prop 65, nutritional warnings, and health claims . + Experience using **ESHA Genesis** for NLEA labeling… more
    Astrix Technology (08/13/25)
    - Related Jobs