• 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)
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  • 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)
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  • 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)
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  • AI Innovation Lead - Data Science Lab

    Guardian Life (Sacramento, CA)
    ** Lead AI Innovation Lead - Data Science Lab** **Overview** Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company ... of pioneering research into practical, enterprise-wide solutions. In this role as Managing Lead Data Scientist for the DSL, you'll be entrusted with the crucial task… more
    Guardian Life (06/27/25)
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  • Medicaid State Technology Lead

    Humana (Sacramento, CA)
    …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... and help us put health first** The State Technology Lead understands departmental and IT organizational strategy and operating...transitioned smoothly to markets. + Works with the Test Lead to develop plans of action for testing new… more
    Humana (08/19/25)
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  • 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)
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  • (USA) Member Team Lead

    Walmart (Long Beach, CA)
    …types, programs, and benefits to current and prospective members; processing memberships, upgrades, and credit accounts; encouraging membership renewals; ... up orders are filled. Oversees assigned area of responsibility by handling claims and returns; zoning the area; arranging and organizing merchandise; identifying… more
    Walmart (08/15/25)
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  • Care Center Lead , Surgical Specialties

    Sutter Health (Fairfield, CA)
    …constant fast paced workload. + Requires ability to learn all Care Center related claims processing functions and pass a skill assessment for each application. ... **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday **Weekend Requirements:** None **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Employees of… more
    Sutter Health (08/15/25)
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  • (USA) Member Team Lead

    Walmart (Santa Clarita, CA)
    …types programs and benefits to current and prospective members processing memberships upgrades and credit accounts encouraging membership renewals participating ... up orders are filled Oversees assigned area of responsibility by handling claims and returns zoning the area arranging and organizing merchandise identifying shrink… more
    Walmart (08/15/25)
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  • DSNP Business Analyst

    NTT DATA North America (Merced, CA)
    …and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing . The ideal candidate will bring a strong understanding ... stakeholders. + Develop and maintain test plans with a focus on D-SNP-related claims processing scenarios. + Assess downstream implications of changes across the… more
    NTT DATA North America (07/18/25)
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