The IT Audit Lead will oversee IS audits, develop methodologies, ensure compliance with IIA standards, advise on technology risks, and innovate audit practices.

The Quality Program Manager drives clinical quality and compliance in Utilization Management, focusing on AI integration and operational efficiency. Responsibilities include overseeing audits, analyzing performance metrics, and ensuring adherence to regulatory guidelines.

The Payment Integrity Concept Lead will research cost-saving opportunities, develop new payment integrity concepts, and design operational workflows to implement them effectively.

The role involves managing provider escalations, developing processes for claims, collaborating with multiple teams, analyzing trends, and creating documentation. It focuses on enhancing operational efficiency and building strong provider relationships.

The Claims & Payments Director leads claims policy strategy, interfaces with providers, reviews complex claims, and influences organizational strategies for claims compliance and payment accuracy.

The Senior Compliance Analyst will audit, track compliance issues, collaborate with teams, analyze data, and support risk assessments.