Oversee delegated audits related to UM, Credentialing, Claims, Enrollment, and Appeals processes to ensure compliance with payer contracts.
Educate staff, update policies and workflows, and act as a liaison between payers and local market leadership during audits.
Operationalize regulatory communications from governing bodies and document process changes for upstream and downstream teams.
Dignity Health Management Services offers integrated management and business services to healthcare providers, focusing on managed care administrative and clinical services to contain costs and improve quality. It is part of CommonSpirit Health, a large health system with a mission-driven culture centered on community and patient care.
Analyze high-value and complex claims, ensuring alignment with carrier guidelines and regulatory requirements.
Oversee delegated claims operations and third-party administrators, monitoring compliance and quality.
Provide subject matter expertise and process improvements to strengthen claims governance and outcomes.
They are an insurance organization focused on claims governance, compliance, and operational performance. They are a growing company that prioritizes accountability, service quality, and effective risk management.
Leads claims quality assurance strategy and execution to ensure accurate, timely payments and compliance with Medicare, Medicaid, and regulatory requirements.
Drives continuous improvement through data-driven auditing, trend analysis, and cross-functional collaboration.
Directly supervises team members, evaluates performance, and identifies training gaps to strengthen workflows.
WelbeHealth serves vulnerable seniors through shared intention, pioneering spirit, and the courage to love. It is a growing healthcare organization focused on team culture and mission.
Set the strategic direction and long-term roadmap for Extend's regulatory compliance program, spanning licensing, service contracts, and insurance.
Serve as the executive-level owner for regulatory and licensing matters, representing compliance in front of regulators and auditors.
Partner with cross-functional teams to embed compliance requirements into merchant onboarding, customer experience, and product workflows.
Extend provides AI-driven solutions for retailers to enhance post-purchase customer satisfaction and drive revenue growth. The company works with more than 1,000 merchant partners, is backed by prominent technology investors, and is headquartered in downtown San Francisco.
Lead the development and scaling of an AI evaluation function for commercial insurance workflows, managing a team of ~10 domain experts.
Establish quality standards, audit rubrics, and calibration procedures to ensure accuracy across P&C insurance lines.
Collaborate with product and ML engineering teams to translate domain insights into actionable AI improvements.
The company is a partner organization building AI-driven solutions for enterprise commercial insurance workflows. It is establishing a new evaluation team to ensure AI output quality, with a focus on operational excellence and professional development.
You will lead the development and implementation of UPS Health & Safety Standards, driving strategic planning and technical advancement.
You will translate emerging risks and industry best practices into field applications to reduce risk and support business objectives.
You will manage talent development and governance initiatives while collaborating with H&S Leadership across the organization.
Liberty Mutual is a global insurance company that provides property, casualty, and commercial insurance solutions. The company values inclusion, professional development, and workplace flexibility, supporting employees through comprehensive benefits and employee resource groups.
Lead a centralized national compliance team focused on audit readiness, regulatory compliance, and risk management.
Coordinate audits, regulatory inquiries, fraud prevention, and complex customer escalations with internal and external partners.
Drive process improvements, documentation governance, and consistent operating procedures across multiple business units.
This company is a partner organization hiring through Jobgether. It focuses on title, escrow, and settlement services, with a strong emphasis on regulatory compliance and risk management. The culture is remote-first, collaborative, and results-oriented.
Lead consulting engagements and strategic client relationships within the P&C insurance industry.
Define engagement scope, quality standards, and ensure measurable business value for carriers and MGAs.
Develop consulting methodologies, mentor professionals, and support business development across sales and operations.
They provide technology-enabled consulting and advisory services for the property and casualty insurance industry. With more than 30 years of industry experience, they focus on innovation, quality, and long-term client partnerships.
Lead and supervise a team of regulatory specialists managing labeling approvals, drug listings, and medical device submissions.
Oversee FDA compliance, quality investigations, and health hazard evaluations to ensure product integrity.
Collaborate cross-functionally with Quality Assurance, Legal, and external partners to resolve complex regulatory challenges.
The partner company is a pharmaceutical and medical device organization focused on ensuring regulatory compliance and product quality. The company fosters a collaborative and inclusive work environment, emphasizing continuous improvement and professional development.
Conduct compliance audits across a nationwide network of nonprofit chapters to assess policy adherence.
Analyze audit results, document findings, and recommend corrective actions to address identified gaps.
Build trusted relationships with chapter teams and leadership while supporting broader risk management initiatives.
The company is a mission-driven nonprofit organization with a nationwide network of chapters. It focuses on creating meaningful experiences and positive outcomes for children and families, fostering a collaborative and detail-oriented culture.
Lead the Quality Assurance Nurse Investigations Unit, guiding complex investigations into healthcare fraud and regulatory non-compliance.
Apply advanced clinical expertise to ensure accurate, compliant, and defensible investigative outcomes.
Coordinate with executive leadership, review investigation reports, and support strategic initiatives.
Our partner is a state agency that safeguards public healthcare programs by conducting clinical investigations, audits, and regulatory oversight. The organization cultivates a culture of integrity, accountability, and continuous improvement, offering a supportive team environment and comprehensive public-sector benefits.
Generate accurate premium invoices and process payments while ensuring adherence to underwriting guidelines.
Reconcile premium payments, investigate discrepancies, and follow up on overdue accounts.
Support internal and external audits by providing documentation and reconciliations for premium accounting activities.
Ryan Specialty is a specialty insurance firm providing innovative solutions for insurance brokers, agents, and carriers. It is a multi-time winner of Newsweek's Most Loved Workplaces and Insurance Business's Top Insurance Employers, home to some of the brightest talent in the insurance industry.
Adjudicate high-end General Liability claims involving serious injuries, complex coverage scenarios, and legal disputes.
Develop case strategies for satisfactory resolution, coordinating with local counsel, clients, and medical or legal experts.
Work in a remote, flexible environment with opportunities for career growth and comprehensive benefits.
Sedgwick is the world's leading risk and claims administration partner, helping clients navigate the unexpected with expertise and AI-enabled technology. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides a caring culture, professional development, and work-life balance.
Lead and execute sales strategy within the workers' compensation and managed care markets.
Mentor and coach sales representatives while managing your own client portfolio.
Collaborate cross-functionally to expand market presence and drive business growth.
The partner company operates in the workers' compensation and managed care industries. It focuses on driving sales growth, building client relationships, and fostering a results-oriented team culture.
Shape enterprise strategy for provider data quality, governance, and directory accuracy across a nationwide healthcare network.
Lead governance frameworks, auditing programs, and compliance with CMS requirements.
Drive innovation through automation, analytics, and executive stakeholder collaboration.
This role is with a partner company in the healthcare sector, operating a nationwide provider network focused on data quality and governance. The company emphasizes innovation, enterprise-wide transformation, and data-driven decision-making.
Directs service delivery for multi-line accounts, partnering with Underwriting and acting as the key contact for brokers and internal partners.
Handles complex tasks and escalated issues including policy issuance, billing, compliance, and account review.
Trains and supports Underwriting Operations teams, using LEAN principles to enhance the customer experience.
Arch is a specialty insurer providing insurance, reinsurance, and mortgage insurance worldwide. With a 20+ year track record and a position on the S&P 500, it fosters a culture of collaboration, expertise, and innovation.
Manage a portfolio of first-party cyber insurance claims from notification through resolution, supporting the full adjudication process.
Complete structured onboarding and training while working under experienced professionals to build independent claims handling skills.
Collaborate with customers, brokers, legal counsel, and cybersecurity vendors to achieve timely and effective claim outcomes.
A specialized cyber insurance provider that helps clients navigate cyber incidents through dedicated claims management and risk mitigation. The company emphasizes structured training, direct mentorship, and a collaborative culture across claims, underwriting, legal, and security teams.
Review team work for accuracy in nondiscrimination testing and compliance.
Provide coaching and training to junior staff based on quality review findings.
Monitor regulations and contribute to process improvement initiatives.
The company specializes in retirement plan administration and compliance, ensuring accurate and regulatory-compliant services for clients. It is a growing, nationally distributed organization with a fully remote work environment and a strong focus on continuous learning and professional standards.
Own the assurance and controls agenda for Global Risk Solutions, driving audit remediation and strengthening the control environment worldwide.
Partner with underwriting, claims, compliance, and finance leaders across global regions to resolve audit findings and boost attestation quality.
Lead controls audits of external program partners and embed GenAI workflows to speed up mechanical work and focus on judgment.
Liberty Mutual is a global insurance company providing property and casualty insurance and related risk solutions. It fosters an inclusive, values-driven culture with comprehensive benefits and a focus on professional development.
Collaborate with claimants, attorneys, medical providers, and insured businesses to ensure accurate, fair, and efficient claim outcomes.
This company provides workers' compensation claims management services, handling lost-time claims across multiple jurisdictions. The role is fully remote, emphasizing independent work, sound judgment, and high-quality service.