- Molina Healthcare (Dayton, OH)
- …fashion and in accordance with unit standards. **Knowledge/Skills/Abilities** * Trains audit staff on configuration functionality, enhancements and updates. * ... of business rules as they apply to each database. Validate accuracy of configuration and ensure adherence to business and system requirements of customers as it… more
- Molina Healthcare (Dayton, OH)
- …criteria (eg, first-pass resolution, auto-adjudication rate, claims cycle time, audit findings, cost-to-serve). + Process Optimization: Lead current/future-state ... : Ensure alignment to CMS, HIPAA, state regulations, and audit readiness. Establish governance, RAID (risks/assumptions/issues/dependencies), and quality … more
- Elevance Health (Mason, OH)
- …maintaining SLOs/SLAs. + Implements data leadership strategies that include data contracts, quality SLAs, and FHIR-aware design for PHI/PII, with a focus on ... frameworks including fairness/robustness evaluations, red-teaming, and model risk management, ensuring audit readiness (HIPAA, SOC 2, HITRUST). + Defines visions and… more