- 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)
- …a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical ... Director , Primary Care work assignments involve moderately complex to...be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources… more
- Humana (Sacramento, CA)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...be authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources… 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)
- …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 relies on medical background and reviews preauthorization requests for services. The ... Medical Director work assignments involve moderately complex to complex issues...be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources… 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)
- …our caring community and help us put health first** The Associate Director , HEDIS Operations of Non-Standard Supplemental for business operations supports all ... of configuration control, data management, and deficiency reporting. The Associate Director , Data Management requires a solid understanding of how organization… more
- Merck (Sacramento, CA)
- …+ Streamlined transfer of process and product knowledge with reduced error rates Digital CMC will implement digital solutions to install the foundational ... and supply. A key workstream within this initiative is the auto-generation of regulatory filing sections, enabled by a dedicated application designed to create a… 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)
- …understanding of how organization capabilities interrelate across department(s). The Associate Director , Procurement complies with federal and state regulatory ... caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies.… more
- Oracle (Sacramento, CA)
- **Job Description** Oracle seeks a Senior Director of Security Architecture to lead enterprise-wide product security architecture for Oracle Cloud and Applications. ... Ops/SRE, Identity, Data, Privacy, and Compliance to mitigate risk, meet regulatory obligations, and improve resilience. + Establish KPIs/OKRs (risk reduction, review… 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
- Datavant (Sacramento, CA)
- …and Security to support risk mitigation, training, and adherence to regulatory and contractual obligations. This position requires a strong understanding of ... cause analyses to ensure completeness, accuracy, and alignment with regulatory standards. + Serve as an escalation point for...incidents or high-impact cases, coordinating with Legal and the Director of Compliance on next steps. + Monitor privacy… more
- PSI Services (Sacramento, CA)
- …with feeling valued. That's why we've benchmarked all our roles against local market rates and why you'll always see salary details in our job postings. We believe ... a standard 09:00 - 17:30 schedule. The role reports to the Snr Director of Information Security, Governance, Risk and Compliance and may be performed remotely,… more