Director of Configuration & Governance, Claims Systems
L.A. Care Health Plan
A leading health plan provider in Los Angeles seeks a Director of Configuration to oversee the strategy and execution of configuration processes. This role requires expertise in system management, staff leadership, and collaboration across departments to enhance operational efficiency. The ideal candidate will have significant experience in managed care operations and a strong background in configuring adjudication rules and pricing methodologies. A comprehensive benefit package and opportunities for professional development are offered. #J-18808-Ljbffr L.A. Care Health Plan
- A leading health care agency in California is seeking a Director, Configuration. This role develops and oversees the configuration strategy for administrative platforms, ensuring effective governance and operational excellence. Candidates should have extensive experience...Claims
$135.14k
...to conduct the search for a Director, Configuration . This position is based in... ...and performance across the claims ecosystem. This role is... ...and compliance to elevate governance, standardization, and execution... ...7 years of experience in a system configuration or managed care...ClaimsWork at office- ...over 5 years. Job Description Director of Corporate Systems Location: Los Angeles, CA (... ...orchestration. As well as light application configuration activities as needed to deliver... ...Systems leader and liaise with the governance as well as operations director...SuggestedFull timeWork at office
$250k - $300k
...transformation across health plan operations, systems infrastructure, and digital engagement... ...group health plan operations, including claims, member services, utilization management... ...IT and Data functions, including data governance, enterprise data warehousing, predictive...ClaimsHourly payTemporary workRemote workFlexible hours- ...providers efficiently dispute underpaid claims, reduce administrative burden, and recover... ...People Operations Generalist to own the systems, processes, and day‑to‑day... ...provisioning, and ongoing admin Support Ashby configuration: interview scheduling, rec IDs, pod setup...ClaimsRemote workFlexible hours
- ...may arise from other departments ( i.e., Pension, Eligibility, Claims, Accounting and Contributions & Compliance) as assigned by the... ...entry. Familiarity with transcription, proofreading, filing systems, and clerical procedures to ensure accuracy and efficiency....ClaimsWork at office
- ...site network growth Operations, Systems & AI-Enabled Infrastructure • Implement... ..., sponsor reporting, CTMS configuration, regulatory tracking, and the... ...waterfall mechanics Cross-Functional & Governance • Reports into the CEO and Managing Director • Contribute to strategic...Local areaRemote work
$142.6k - $261.5k
...solution “hot spots” exist today, such as in claims, underwriting, policy and billing. Our... ...-enabled transformation: Guidewire System Implementation (Policy, Billing, Claims,... .../Authorization, FIGMA, APIs, and configuration Develop and operationalize Guidewire...ClaimsWork experience placementSummer holidayFlexible hours- ...Discovery Business and System Analyst Employment Type: Full-Time... ...people together to solve the government's most dynamic problems with... ...solution providers that claim to satisfy the identified business... ...shall review all solution configuration changes to insure that the Discovery...ClaimsFull timeFor contractorsWork at officeFlexible hours
$47.94 - $69.18 per hour
...Principal Information Systems Analyst - Lead EDI Developer Salary Range: $47.94-$69.... ...on homelessness services into Medicaid claims and managing the end-to-end Electronic Data... ...of new service types or program configurations. Contribute to process automation, monitoring...ClaimsHourly payFull timeWork at officeRemote work$206.31k
...Medical Director, Clinical Policy Job Category: Clinical Department... ..., implementation, governance, and evaluation of clinical... ...requirements, coding structures, and system configuration through partnership with... ...the organization. Analyze claims data, utilization trends,...ClaimsFull timeLocal area$119.11k - $160.52k
...to fill emergency Principal Information Systems Analyst vacancies related to the homelessness... ...application system, controlling system configuration such as data dictionaries, configuration... .... Los Angeles County will not consider claims of not viewing or receiving notification...ClaimsPermanent employmentFull timeContract workWork experience placementWork at officeLocal area$132.29k - $155.86k
...Director, Claims Triage Argo Group is an underwriter of specialty insurance products in the... ...the design, building, and manage an AI system based on LLM that is reliable, adaptable... ...Consistently considers all options and is not governed by conventional thinking. Ability to...ClaimsWork at office$120k - $165k
...SUMMARY/OBJECTIVE The Global Director of Compensation & Benefits... ...for the strategic oversight, governance, and execution of global... ...leads improvements to payroll systems, vendors, workflows, and global... ...administration, unemployment claims, and coordination of leave...ClaimsMinimum wageLocal area$170.45k - $278.91k
...Senior Director, US Medical & Pharmacy Comcast brings together... ...discussions as part of ongoing plan governance (Benefits Fiduciary and... ...annual accrual rate setting, claims reforecasting, Incurred but Not... ...part of the Net Promoter System - a way of working that brings...ClaimsContract workLocal area$124k - $280k
...optimising algorithms, models, and systems to enable intelligent... ...processing clinical notes, claims data, ADT feeds, and other structured... ...MLOps practices, and model governance across client engagements... ...and HIPAA-aligned cloud configurations; Experience with data warehouse...ClaimsFull timeH1b$169k - $281k
...STEM OPT. Position Summary: The Director, R&D Optimization, has responsibility... ...a Product Lifecycle Management (PLM) system. Advanced meeting facilitation skills... ...individuals, organizations, and internet sites claiming to represent Pharmavite in recruitment...ClaimsHourly payWork at officeLocal areaWork from home$135.14k
...Director, Claims Administration Job Category: Management/Executive Department: Claims Integrity... ...The Director, Claims Administration, governs enterprise outcomes and risk controls,... ...and operational readiness for benefit, system, or regulatory changes. The role serves...ClaimsPermanent employmentFull timeContract workWork at office- ...tile and stone installation systems and building finishing solutions... ...InsurancePosition SummaryThe Director, Legal will serve as the sole... ...business with professional governance. The role interacts with U.S.... ...InsuranceManage all litigation, claims, investigations, and dispute...ClaimsContract workLocal areaRemote workWorldwide
$90k - $140k
...Someone who has transitioned from manual processes to more automated systems # Full cycle recruiting experience a must Essential... .... ~ Oversee and coordinate workers' compensation claims and ensure compliance with Cal/OSHA and state requirements. ~...ClaimsLocal area- ...Director, Human Resources role at AHMC HealthCare Directly responsible for planning,... ...Managing workers’ compensation program, claims handling, and coordinating with industrial... ...with HR/Payroll computerized information systems. General mathematical and budgeting skills...ClaimsContract workLocal area
$120k
...management. Reporting directly to the HR Director, this position serves as the organization... ...communications, vendor coordination, system updates, and enrollment audits. •... ...leaves of absence. • Manage unemployment claims and employment verification requests. •...ClaimsLocal area- ...serves as a key partner to the Director of General Affairs, providing... ...support across governance, compliance, office operations... ...insurance operations such as claims submission, follow-up, tracking... ...Manage the contract management system, ensuring all records are accurate...ClaimsContract workWork at officeRemote workWorldwide
- ...Manage vendor billing reviews and benefit reconciliations Support claims inquiries and serve as the primary point of contact for... ...enterprise HRIS platforms, benefits modules, and leave management systems Experience with retirement plan administration and equity compensation...Claims
$115k - $170k
...California hospital -recognized with an "A" grade in patient safety by The Leapfrog Group -is seeking an experienced Director of Information Systems to lead its technology strategy and digital transformation. This high-impact role reports directly to the Chief...Full time$34.7 - $54.22 per hour
...Experience is required in Guidewire Policy, Claims, and Billing integration development.... ...issues identified during testing of configuration requirements. Handle code merges and environment... ...processes connecting with Guidewire systems. Design and develop adapters, service...ClaimsContract work$250k - $280k
...Director Of Corporate Systems, ERP As a Director, Corporate Systems ERP, you will be responsible for plan, design and development of Oracle Fusion ERP and other Supporting Systems. Reporting to the Vice President of Corporate Systems you will be responsible for software...$220k - $260k
...Director of Space Systems | Los Angeles, CA We’re working with a stealth-mode space startup on a mission to build the first orbital energy utility - delivering power in space via optical laser-based transfer systems . Backed by tier-1 investors and led by industry...$175k - $220k
...Supplier Quality, Hardware Quality, and Configuration Management. Establish independent... ...requirements. Build scalable mission assurance systems supporting production scale.... ...configuration integrity including ECO/ECN governance and serialized tracking. Maintain...Work experience placementCasual workRelocation package$175k - $220k
...Supplier Quality, Hardware Quality, and Configuration Management. Establish independent... ...requirements. Build scalable mission assurance systems supporting production scale.... ...configuration integrity including ECO/ECN governance and serialized tracking. ~ Maintain...For contractorsFor subcontractorCasual workRelocation package
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