The VP and Chief Actuary leads enterprise actuarial services, underwriting, and risk management to ensure financial sustainability and regulatory compliance. This role provides strategic guidance to executive leadership on growth initiatives, product development, and long-term financial performance.
The specialist administers enterprise print governance processes and manages relationships with print and fulfillment vendors. They also oversee document lifecycle activities, monitor vendor performance, and identify opportunities for operational efficiency and cost savings.
The Document Services Coordinator manages enterprise document requests, workflow activities, and governance processes to ensure efficient and compliant service delivery. They also coordinate vendor interactions, maintain project records, and provide operational status reports to stakeholders.
The Team Lead provides operational leadership for document, fulfillment, and mail services by directing workflows, supervising staff, and monitoring service levels. They also partner with leadership to implement strategic initiatives and ensure compliance with organizational standards.
The specialist is responsible for overseeing enterprise document intake and vendor-supported mail operations to ensure accurate routing, tracking, and processing. They also monitor performance metrics, manage OCR quality, and identify process improvements to enhance operational efficiency.
The Business Systems Analyst serves as the primary liaison for enterprise document management, print, and fulfillment operations. They are responsible for gathering requirements, facilitating system enhancements, and troubleshooting production issues in collaboration with stakeholders.
The Manager oversees and directs utilization management operations for inpatient, post-acute, and DSNP services to ensure regulatory compliance and cost-effective care. This role also leads interdisciplinary teams, manages departmental budgets, and implements process improvements to enhance member outcomes.
The Senior Accountant is responsible for preparing GAAP, statutory, and regulatory financial reports for PacificSource and its subsidiaries. They also manage the income tax provision and compliance cycle while identifying opportunities for process improvement and automation.
This role oversees the Provider Network department's core operational, data, and systems functions, including credentialing, provider relations, and platform interoperability. The director leads strategic planning and execution to ensure high performance across all lines of business while fostering partnerships and optimizing system compatibility.
The Senior Fraud, Waste and Abuse Investigator manages complex healthcare audits and investigations to ensure compliance with state and federal regulations. They collaborate with cross-functional teams to identify patterns of fraud, conduct fact-finding interviews, and serve as a subject matter expert for the organization.
The Senior Fraud, Waste and Abuse Investigator manages complex healthcare audits and investigations to ensure compliance with state and federal regulations. They collaborate with cross-functional teams to identify patterns of fraud and present findings to management and regulatory agencies.
The Senior FWA Specialist serves as a subject matter expert responsible for supporting and advancing payment integrity and fraud, waste, and abuse programs. This role involves developing policies, managing audits, coordinating with regulatory agencies, and analyzing claims data to identify and mitigate financial risks.
The Senior FWA Specialist serves as a subject matter expert responsible for developing and maintaining payment integrity and fraud, waste, and abuse programs. This role involves coordinating audits, managing regulatory reporting, and collaborating with internal and external stakeholders to detect and prevent financial risks.
The Senior FWA Specialist serves as a subject matter expert responsible for developing and maintaining the organization's Payment Integrity and FWA program framework. This role involves leading investigations, managing regulatory reporting, coordinating audits, and collaborating with internal and external stakeholders to prevent and recover fraudulent payments.
The Senior FWA Specialist serves as a subject matter expert responsible for developing and maintaining the organization's Payment Integrity and Fraud, Waste, and Abuse programs. This role leads investigations, manages regulatory reporting, coordinates audits, and collaborates with internal and external stakeholders to mitigate financial risks.
Develop and administer compensation programs and guidelines aligned with the company's philosophy to attract and retain talent. Manage direct compensation processing, conduct market benchmarking, and ensure compliance with federal and state regulations.
Develop and administer compensation programs and guidelines that align with the company's philosophy and organizational culture. Partner with business leaders to manage job evaluations, salary benchmarking, and compliance with federal and state laws.
Develop and administer compensation programs and guidelines aligned with the company's philosophy to attract and retain talent. Manage direct compensation administration, conduct market benchmarking, and ensure compliance with federal and state laws.
Develop and administer compensation programs to support the company's philosophy and talent retention. Manage direct compensation administration, conduct market benchmarking, and ensure compliance with federal and state laws.
Develop and administer compensation programs and guidelines that align with the company's philosophy and organizational culture. Partner with business leaders to manage job evaluations, salary benchmarking, and the administration of direct compensation within the Workday HRIS.
Develop and administer compensation programs to support the company's philosophy and talent retention. Manage direct compensation administration, conduct market benchmarking, and ensure compliance with federal and state laws.
The Senior Risk Adjustment Analyst ensures accurate data submission to regulatory entities like CMS and optimizes risk models for HCCs and HEDIS performance. The role involves collaborating with internal and external partners to improve processes, maintain documentation, and provide mentorship to junior analysts.
The Senior Risk Adjustment Analyst ensures accurate data submission to regulatory entities like CMS and optimizes risk models for HCCs and HEDIS performance. The role involves collaborating with internal and external partners to improve processes, maintain documentation, and provide mentorship to junior analysts.
Coordinate healthcare delivery by performing utilization management services and concurrent reviews to ensure cost-effective, quality care. Collaborate with multidisciplinary teams to manage member benefits, preauthorizations, and discharge planning.
Coordinate healthcare delivery by performing utilization management services and concurrent reviews to ensure cost-effective, quality care. Collaborate with multidisciplinary teams to manage member benefits, preauthorizations, and discharge planning.
