16 director network compliance jobs found in Madison

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job Description Job Summary Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable. Job Duties Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Network Management Consultant - Remote Job Description The Network Management Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This includes development of network contracts, participation requirements, analysis of pharmacies, and ensuring contract and regulatory compliance. This position is accountable for creation and management of specialty fee schedules to ensure competitiveness and serves as the liaison between Prime's Network Management and Specialty teams. Responsibilities Negotiate market competitive high-profile and/or complex...

Work at Home - Decision Quality and Controls, Principal Process Manager Decision Quality and Controls is the face of Monitoring and Controls for Customer Protection. We take Quality monitoring to the next level by designing controls that are criteria based targeting key failure modes and testable meeting Enterprise Standards. We are looking for a process engineer with expertise in Data and Reporting that will fast track us into automation. In this role you will partner with key stakeholders across Retail Bank Fraud to automate and enhance dashboards, processes and reporting and craft compelling stories backed by data. What We're Looking For In This Role: Drive forward strategy for execution of controls support including process assessments and enhancements, make recommendations and influence change Leads, influences, and mentors associates within a dotted line team through large and/or complex process or projects with significant impact, delegating and...

Job Description Oracle's Global Physical Security (GPS) Systems Team is responsible for securing the corporation's global datacenter and facility footprint through advanced Physical Access and Identity Management (PIAM) technologies. We are seeking a seasoned Technical Program Manager (TPM) for Wireless Intrusion Detection Systems (WIDS) who will own the end-to-end lifecycle of enterprise wireless detection, monitoring, and counter-surveillance solutions for a complex and global security environment. Reporting to the Director, Physical Security Products & Services, you will lead the technical roadmap, policies, education, and integrations necessary for WIDS excellence-partnering closely with security operations, engineering, data center operations, and end-user groups. Responsibilities Product & Program Ownership Own the lifecycle management, standards, and feature evolution for all Wireless Intrusion Detection Systems (WIDS), including integration with...

Senior Manager, Sourcing Location: Remote, United States Description Dodge Construction Network (Dodge) is searching for a Senior Manager, Sourcing to join our team!TheSenior Manager,Sourcingis responsible for driving Dodge'sdata acquisition strategy, including digital sourcing and supplier management. This roleleadsthe sourcing of high-value construction project data from all stages of the construction lifecycle for public and private sources, including web-scraping, external data partnerships, Construction groups and associations, FOIA pipelines, and targeted outreach to construction stakeholders. The SeniorManager,Sourcingwill define and balance sourcing strategy, ensure ongoing quality and consistency of the data being collected, andpartnercross-functionally with Content Operations, Product, and Engineering to support scalable coverage and growth. This is a full-time position and reports directly to the Director,Data Acquisition. Preferred Location This is a...

Data Governance Manager Location: Remote, United States Description The DataGovernance Manager owns Dodge's Standard Operating Procedure (SOP) ecosystem, ensuring operational documentation remains current, compliant, and accessible across the Content organization. This role serves as the central point of coordination for SOP lifecycle management-working with subject matter experts, team leads, and managers to schedule reviews, maintain version control, and promote consistent adoption of best practices. This is a full-time position and reports directly to the Sr. Manager, Operational Performance Management. Preferred Location This is a remote, home-office based role and candidates located in the continental United States will be considered.For this position, there is a preference to hire in Easterntimezone, however candidates in other area/time zones would be considered as well. Travel Requirements Expected travel is minor for this role. Essential...

Summary: Meta is a global leader in terrestrial and subsea network investment. Meta is continuously expanding our network infrastructure around the Globe to support our data centers, our fast growing user community and the new and innovative products that we are making available for our users. Developing, operating and managing network infrastructure the "right" way is synonymous with ensuring on-time delivery, high uptime, capacity availability, flexibility and capital cost efficiency in a safe and compliant working environment. Meta is seeking an environmental compliance program manager to manage environmental due diligence, permitting, and compliance for our fiber optic cable infrastructure portfolio. This position will primarily support the NORAM region to oversee and mitigate environmental risks for terrestrial network projects and coordinate with cross-functional teams, including network investments, construction and operational teams, legal, policy and communications....

Guides, directs, and coaches employees to deliver exceptional service to BMO customers and prospects. Understands the needs of BMO customers or prospects to provide sales and service in the best interests of the customer. Advises customers on products and strategies that meet their financial objectives. Identifies and makes referrals to other business groups. Supports sales and customer service activities to meet strategic customer experience and profitability goals in compliance with legal and regulatory requirements and the Bank's policies and processes. U.S. Only: This position will act as an originator of consumer loans as defined by Regulation Z, Regulation G, and the Secure and Fair Enforcement for Mortgage Licensing Act (the S.A.F.E. Act). This position will require a Federal registration with the Nationwide Mortgage Licensing System and Registry. The Bank will instruct you on the registration requirements needed to comply with this requirement. A criminal background...

Job Description Team Overview The Data Center Infrastructure Delivery team at Oracle Cloud Infrastructure is a dynamic group of professionals dedicated to delivering state-of-the-art data center facilities at scale and at pace. This team comprises experienced project managers who work collaboratively with vendors and internal teams to ensure the successful execution of complex data center construction and network projects. They bring a wealth of expertise in project management, technical design, and on-site construction, ensuring that our data centers meet the highest standards of quality, efficiency, and sustainability. This team plays a crucial role in supporting Oracle Cloud Infrastructure's data needs and driving our growth and success. Job Summary Strategically, you will be responsible for developing and implementing comprehensive plans that optimize efficiency, cost-effectiveness, and operational excellence in delivery. You will engage with key stakeholders,...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Western Digital. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Company Description At Western Digital, our vision is to power global innovation and push the boundaries of technology to make what you thought was once impossible, possible. At our core, Western Digital is a company of problem solvers. People achieve extraordinary things given the right technology. For decades, we’ve been doing just that. Our technology helped people put a man on the moon. We are a key partner to some of the largest and highest growth organizations in...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Account Manager - Remote Job Description The Account Manager provides information, analyses, and consulting to Health Plan and Prime senior management. The Account Manager supports senior management and Health Plan Markets teams in communications, client-facing initiatives, including a focus on managing projects and issue management. This role must establish and maintain relationships with designated client counterparts in the pharmacy department and other key client functions as determined by the Sr. Director/Director. Responsibilities Perform business analysis work for client-facing needs. Knowledge of PBM functions such as but not limited to customer service, claims, benefits, prior authorizations,...

Job Description GM Energy is building a best-in-class installation ecosystem to support the next generation of home energy products. As the Group Manager, Home Product Installation & Interconnection, you will define and execute the strategic approach for how GM Energy delivers residential installations across a diverse national network of certified installers, turnkey providers, and customer-selected electricians. In this role, you will shape the operational model that enables speed, quality, and customer confidence, from installer onboarding and market enablement to in-flight performance, compliance, and long-term network health. You will work across GM Policy, Energy Sales, Business Development, Product Development, and Customer Care to eliminate friction points, reduce barriers to EV adoption, and ensure GM customers experience a level of service and support unlike anything in the market. This position is a unique opportunity to architect the systems, standards,...

Job Description In this role, you will manage assigned portions of the design process for both new builds and retrofit projects. You'll support the delivery of design documentation, provide technical coordination, and assist with early-stage due diligence. The ideal candidate has strong technical knowledge in MEP systems, the ability to manage multiple design packages simultaneously, and a passion for delivering best-in-class data center infrastructure. You will work under the direction of senior team members and collaborate closely with OCI's engineering, construction, and operations teams to ensure project success. 50% travel required Responsibilities Responsibilities: Support the full lifecycle of design activities for data center projects, including planning, consultant coordination, and design review Assist with the development and tracking of project design schedules and deliverables Review consultant design packages (SD, DD, IFC) for alignment...

Job Description It is an exciting time to be a part of the Oracle Cloud Development organization. As we continue to rapidly introduce new products and enhancements, we are focused on delivering AI capabilities that will help customers automate and transform their business processes. We recently launched an AI Agent Marketplace where trusted, validated AI Agent templates from our global network of certified partners are embedded into Fusion AI Agent Studio alongside Oracle pre-built AI Agent templates. As we continue to grow the Marketplace, we are looking for a strategic, execution-focused program manager to help drive the operational and program management foundation of this platform. This role will ensure the marketplace runs smoothly, scales responsibly, and delivers an exceptional experience for customers and Marketplace partners. As the Fusion COE Operations + Program Manager, you will design processes, manage cross-functional communication, and drive operational...

Job Description About the Role: As a Program Manager - Regulatory & Compliance Enablement in the Healthcare and Lifesciences Compliance Organization (HCO), you will work directly with the Senior Director Senior Director, Regulatory & Compliance Enablement, HCO, compliance & regulatory teams as well as our internal business groups to help address regulatory compliance issues that are essential to Oracle customers of all sizes globally with a focus on the healthcare industries. The team works to build new and creative approaches to business adoption of regulatory and compliance programs, and to facilitate systems and process that enable Oracle's products and services by such customers in a regulatory and compliance protected manner. We advise and collaborate with Oracle business leaders and external specialists on sophisticated, industry leading legal and regulatory compliance matters. Preferred Qualifications: BA/BS degree and 4 years of experience...