- American Water (Sacramento, CA)
- …business partner providing advice for California and Hawaii ensuring coordination of rates and regulatory strategy with state operations, functional groups ... diverse pipeline of talent to enable long-term high performance of the rates and regulatory function. Oversees complex rate and regulatory proceedings for… more
- CenterWell (Sacramento, CA)
- …our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for ... and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy Advancement and… more
- Datavant (Sacramento, CA)
- …experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the ... suite. + Define multi-year plans aligned to customer outcomes, regulatory drivers, and market trends in risk adjustment, care...risk score impact, and concurrent coding capture and correction rates . + Establish and track KPIs that measure both… more
- Datavant (Sacramento, CA)
- …experiences to realize our bold vision for healthcare. **Role Summary:** The ** Director of Internal Audit** will design, implement, and oversee Datavant's legal and ... audit standards. Reporting to the Chief Compliance and Privacy Officer, the Director of Internal Audit will evaluate the effectiveness of internal controls, risk… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national… more
- PSI Services (Sacramento, CA)
- **Description** **Title:** Sr. Director , Federal Program Management **Location:** Remote-US **Salary:** $175K / annually + STIP **About PSI** Join Us at PSI - Where ... why we've benchmarked all our roles against local market rates and why you'll always see salary details in...aligns with your expectations. **About the Role** The Senior Director , Federal Program Management is a critical leadership role… more
- Baylor Scott & White Health (Sacramento, CA)
- …implementing policies, procedures and performance metrics to improve appeal success rates , ensure regulatory compliance and optimize reimbursement outcomes. Will ... **Job Summary** The Director , Denial Resource Center is responsible for the...Strong understanding of payer denial codes, appeal strategies and regulatory frameworks. + Familiarity with RAC audit processes preferred… more
- Humana (Sacramento, CA)
- …caring community and help us put health first** The Associate Director ; Software Renewals establishes and implements hardware and software acquisition, protection, ... procedures that are aligned with IT standards and strategy. The Associate Director ; Software Renewals requires a solid understanding of how organization capabilities… more
- Humana (Sacramento, CA)
- …to deliver agile, data-driven, and personalized member experiences at scale. As Director of Marketing Communication Operations, you will play a pivotal leadership ... to advance shared objectives and support organizational growth **Compliance, Risk & Regulatory Leadership** + Serve as a subject matter expert on CMS, Medicaid,… more
- Elevance Health (Walnut Creek, CA)
- **Provider Network Management Director ** **Location:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... accommodation is granted as required by law. The **Provider Network Management Director ** is responsible for developing and managing the provider network through… more
- Vontier (Sacramento, CA)
- We are seeking a highly skilled and experienced Sr. Director of Global Payroll and Compliance to lead the strategy, execution, and continuous improvement of payroll ... operations and regulatory human resource/payroll compliance across all countries where the...and monitor key metrics and SLAs (payroll accuracy, on-time rates , cost per payroll transaction, audit remediation timelines) and… more
- Wolters Kluwer (Sacramento, CA)
- …Consolidation & Reporting, CCH Tagetik has developed pre-packaged solutions addressing regulatory reporting requirements for ESG, Tax, Insurance & Banking. The ... **North American** team is seeking a ** Director of Solution Consulting, North America** to lead a...+ Track and report on key performance metrics (win rates , demo quality, utilization). + Optimize pre-sales processes and… more
- Travelers Insurance Company (Sacramento, CA)
- …regularly engage in unique and intellectually stimulating business problems. As a Director , Product Management, you will manage the growth and profitability for ... in the formulation of recommendations based on analysis and interpretation of rates , data, and trends to achieve business objectives. By collaborating and… more
- Evolent (Sacramento, CA)
- …of our specialty programs and administrative platform. Role Overview The Associate Director role on Client Analytics will support both internal teams (EAS, Specialty ... partners. + Advanced Reporting & Compliance: Lead the development of regulatory and ad hoc reporting strategies, ensuring accuracy, compliance, and alignment… more
- Banfield Pet Hospital (Walnut Creek, CA)
- …and dental skills based on individual veterinarian needs. + Partner with the Director of Veterinary Quality and Talent Acquisition team to recruit veterinary talent. ... event reviews. Hospital operations must meet all local, state and federal regulatory requirements including but not limited to compliance with controlled substance… more