- CVS Health (Sacramento, CA)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team. To be successful in this role,… more
- Elevance Health (Costa Mesa, CA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... processing authorizations. + Contacts facilities identified by the UM Nurses/ Manager /Director/Medical Director to research any issues (ie contract, discharges,… more
- Prime Healthcare (Ontario, CA)
- …terminations. . Maintains accurate records of contracts and related documentation. Risk Management:. Identifies potential risks associated with contracts. . Develops ... and implements risk mitigation strategies. . May be involved in contract claims and disputes. Compliance and Legal Issues:. Ensures compliance with relevant… more
- Envista Holdings Corporation (Pomona, CA)
- …possess a deep understanding of quality management systems, regulatory requirements, and risk management principles. The Sr. Quality Engineer will report directly to ... the Quality Engineering Manager . **ESSENTIAL DUTIES AND RESPONSIBILITIES:** + Actively participates in defining customer requirement, product claims and target… more
- Zurich NA (Los Angeles, CA)
- …finance or senior sales management (eg GM, GSM, Finance Director, Finance Manager ). * Experience in dealership training (1:1, classroom, virtual). * Proficiency in ... and traditional software/technology. * Knowledge of insurance, reinsurance, and warranty claims processes and F&I products. * Ability to analyze financial… more
- Banc of California (Santa Ana, CA)
- …(ACH) transactions, Large on-us & Unusual items, Stop payment, ATM/Mobile/RDC Deposits, Check Claims , Fraud alerts for Wire, ACH & Debit Card, Wire Transfer. + ... with higher limits and at times, can approve/verify on behalf of the manager and stays within Operational Transactional Signing Authority. Can be cross trained and… more
- Atlas (San Diego, CA)
- …management reviews. Reports may include resource loading analysis, critical path items, and risk analysis. + Assist the project manager in creating and ... objectives are successfully met. **Key Responsibilities:** + **Contract Compliance & Risk Management:** + Review contractor schedules for compliance with project… more
- Medtronic (Irvine, CA)
- …and compliantly. + Advise on federal healthcare laws, antikickback, antitrust, False Claims Act, HIPAA, state data privacy and security laws, software licensing, FDA ... law, IP and other legal risk areas governing data-enabled healthcare technology and AI commercial...computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions… more
- The County of Los Angeles (Los Angeles, CA)
- …audits relating to law enforcement operations. This classification acts as a project manager and is distinguished by its role in providing technical guidance to ... law enforcement investigative operations, practices, policies and procedures, focusing on high- risk areas and its compliance to policies and procedures; determining… more
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