• Managed Care , Claims

    Zurich NA (Sacramento, CA)
    Managed Care , Claims Vendor Management Sr Specialist 118916 Zurich North America is seeking a Managed Care , Claims Vendor Management ... United States. **About the Role** As a Senior Specialist in Managed Care and Claims Vendor Management, you will play a key role in administering… more
    Zurich NA (12/18/24)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Sacramento, CA)
    …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
    Humana (12/19/24)
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  • Business Consultant

    HealthEdge Software Inc (Sacramento, CA)
    …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
    HealthEdge Software Inc (12/18/24)
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  • Director, Revenue Division

    Sutter Health (Sacramento, CA)
    …depth knowledge of third-party billing rules for Medicare, Medi-Cal, Government Managed Care , Health Maintenance Organization (HMO), Preferred Provider ... revenue & revenue cycle functions, using internal and third-party vendor analytics. High impact areas include front end operations,...providing education and support to staff in both the care centers and finance & revenue cycle on system… more
    Sutter Health (10/24/24)
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  • Associate Director, Global Labeling Lead - Remote

    Takeda Pharmaceuticals (Sacramento, CA)
    Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
    Takeda Pharmaceuticals (10/16/24)
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