- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- LA Care Health Plan (Los Angeles, CA)
- Director , Payment Integrity Job...7 years of deep experience in Payment Integrity , Fraud/Waste/Abuse prevention, Claims Accuracy, Medical Cost ... residents and to support the safety net required to achieve that purpose. Job Summary The Director , Payment Integrity defines the payment integrity … more
- TEKsystems (Martinez, CA)
- …partners to align claims operations, with accountability for claims adjudication, payment integrity , regulatory compliance, and vendor oversight across Medi-Cal, ... oversight of all CCHP claims operations, including claims adjudication, adjustments, payment integrity , and recovery activities * Setting departmental strategy,… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- The Associate Director , Congress and Medical Education Strategy & Execution is responsible for executing and contributing to the global medical strategy and ... through deep scientific understanding and collaborative partnerships. The Associate Director partners closely with global and regional cross-functional stakeholders… more
- LA Care Health Plan (Los Angeles, CA)
- Director , Claims Administration Job Category: Management/Executive Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Director , Claims Administration, governs enterprise outcomes and risk controls, introducing a… more
- LA Care Health Plan (Los Angeles, CA)
- …consistent, predictable outcomes across Claims Administration, Configuration, Payment Integrity , and related operational areas. The Director oversees ... Director , Center of Excellence and Quality Assurance Job...adopt compliant practices. Directs compliance monitoring of claims processing, Payment Integrity interventions, configuration changes, and related… more
- LA Care Health Plan (Los Angeles, CA)
- …and optimizing LA Care's core administrative functions, including Claims Administration, Payment Integrity , Configuration, Electronic Dara Interchange (EDI) and ... and multi-functional departments in managed care operations, including Claims Administration, Payment Integrity , Configuration, or similar functions At least 8… more
- Mastercard (San Francisco, CA)
- …and governments realize their greatest potential._ **Title and Summary** Director , Agentic Commerce Solution Engineering Director , Solution Engineering, ... providers, startups, large issuers, digital wallets, merchants, acquirers, and payment service providers to execute Mastercard's digital strategy, while identifying… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …leading cross-functional study teams, and ensuring the highest standards of scientific and medical integrity . The incumbent will be responsible for the design ... to create so that we can provide answers to medical needs that have yet to be addressed. Another...Summary** Otsuka is seeking an experienced and visionary Senior Director , Global Clinical Development (GCD), with experience in immunology,… more
- Evolent (Sacramento, CA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Director , Client Value** **About Evolent** Evolent Health partners with health plans and ... We are committed to transforming healthcare for the better. **Role Overview** The ** Director , Client Value** will serve as a key member of the Client Value… more
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