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PT
Senior Compliance Analyst (Regulatory Change Management) - Remote
Prime Therapeutics Jefferson City, MO, USA
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 Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...

Dec 21, 2025
CT
Financial Management Analyst - Senior
Cgi Technologies Corporation Missouri City, MO, USA
Financial Management Analyst - Senior Category: Finance Main location: United States, Missouri, Arlington Position ID: J1225-0711 Employment Type: Full Time Position Description: The Senior Financial Management Analyst position will provide Information Technology Risk and Analysis Services to Headquarters Marine Corps (HQMC) Deputy Commandant for Information (DCI) Chief Information Officer (CIO) Information Command Control Communications Computers (IC4) Division. Services include establishing internal controls and a Risk Management Framework to provide reasonable assurance that IT system process weaknesses can be prevented or detected early enough to mitigate and prevent an adverse impact on the organization. We are seeking a highly motivated and skilled Financial Management and Audit Compliance Specialist to provide expert-level support to our client. The candidate will play a critical role in ensuring compliance with government and DoD regulations,...

Dec 12, 2025
Highmark Health
Senior Change Management and Process Improvement Consultant
Highmark Health Jefferson City, MO, USA
Company : Highmark Health Job Description : JOB SUMMARY *This will be a hybrid role if you live within a 50 mile radius a Highmark Office This senior-level job will lead and facilitate integrated process improvement and change management initiatives across multiple functional units Responsibilities encompass designing and implementing process optimization strategies, developing and executing comprehensive change management plans across all impacted stakeholders throughout the change lifecycle, coaching leaders and teams as applicable, and ensuring seamless alignment between people, process, and technology solutions - all while directly contributing to successful business outcomes and ongoing improvements. The successful candidate will leverage expertise in Lean Six Sigma, as well as change management methodologies to drive efficiency, effectiveness, and improved business outcomes. ESSENTIAL RESPONSIBILITIES Process Improvement and Change Management...

Dec 21, 2025
Humana
Care Management Support Assistant
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Dec 21, 2025
Highmark Health
Team Manager IT Project Management
Highmark Health Jefferson City, MO, USA
Company : Highmark Health Job Description : JOB SUMMARY This job will manage the activities of various project management roles as well as directly apply project leadership to multiple large complex product and technology solutions throughout the IT organization. Actively involved in the cultivation of knowledge, coordination, implementation, problem solving, communication, and training of new technologies and processes as they are developed and moved into the department. Project Leadership activities include directly managing team members involved in various programs/projects in conjunction with the organizational need. The incumbent exhibits and applies the core behaviors which define success for the company and our customers: Purposeful Execution, Teamwork, Transformational Leadership, and a Customer-First mentality. Committed to on-time/on-budget delivery, promoting a culture of collaboration among all project stakeholders, thinking and planning strategically in...

Dec 21, 2025
Otsuka Pharmaceutical Companies (U.S.)
Senior Manager, Global Quality Management - Clinical
Otsuka Pharmaceutical Companies (U.S.) Jefferson City, MO, USA
Job Summary The Senior Manager of Global Quality Management (GQM) supports the execution of clinical quality activities to ensure compliance with Good Clinical Practice (GCP), regulatory requirements, and internal standards across global clinical trials. This role provides hands-on quality oversight, supports audit and inspection readiness, and collaborates with internal teams and external partners to maintain high-quality standards throughout the clinical development lifecycle. Key Responsibilities Clinical Study Support Serve as a GCP quality resource to clinical teams during study planning, conduct, and close-out. Support the review of study documents (e.g., protocols, monitoring plans, vendor agreements) for quality and compliance. Assist in identifying and resolving quality issues, protocol deviations, and potential noncompliance. Collaborate with Clinical Operations, Regulatory Affairs, and Medical Affairs to embed quality practices...

Dec 19, 2025
Otsuka Pharmaceutical Companies (U.S.)
Manager, Global Quality Management - Clinical Audit
Otsuka Pharmaceutical Companies (U.S.) Jefferson City, MO, USA
The Global Quality Audit Manager is responsible for planning, executing, and reporting on global audits to ensure Good Clinical Practice (GCP) compliance across Contract Research Organizations (CROs), clinical laboratories, and clinical investigator sites. This role plays a critical part in maintaining the integrity of clinical trial data and ensuring patient safety by verifying adherence to regulatory requirements and internal standards. As a key member of the Global Quality Management team, the Audit Manager will collaborate with cross-functional stakeholders to identify risks, drive continuous improvement, and support inspection readiness across the clinical research landscape. Key Responsibilities Audit Execution : Plan, conduct, and report GCP audits of CROs, clinical laboratories, and investigator sites globally, ensuring compliance with ICH-GCP, local regulations, and company policies. Provide oversight to contract and consultant resources in audit...

Dec 19, 2025
MasterCard
Full time
 
Manager, Sourcing & Supplier Management
MasterCard O'Fallon, MO, USA
Our Purpose Mastercard powers economies and empowers people in 200+ countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Manager, Sourcing & Supplier Management Overview Sourcing & Supplier Management creates and maximizes shareholder value by effectively managing the MasterCard supply base across all business units, focusing on reducing cost & risk while improving value & supplier performance. This organization includes Sourcing Strategy, Sourcing Operations, and Supplier Management and is on a journey to be recognized as a premier supply chain...

Dec 18, 2025
Humana
Workforce Management Professional 1
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Workforce Management Professional 1 work assignments are often straightforward and of moderate complexity. The Workforce Management Professional 1 assesses organizational staffing and identifies requirements and solutions to meet workforce objectives. Provides analysis of talent and staffing needs based on strategic planning at the enterprise level. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented...

Dec 16, 2025
EM
Internship
 
Risk Management Internship - Summer 2026
Enterprise Mobility St. Louis, MO, USA
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 Enterprise Mobility Inc. 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. Overview Are you a college student looking for a rewarding internship that could lead to full-time employment after graduation? Enterprise Fleet Management, a business line of Enterprise Mobility, has multiple opportunities in our Risk Management Department for Risk Management Summer Interns! Company Overview Enterprise Fleet Management is a privately held, full-service fleet management business for companies, government agencies and organizations with...

Dec 14, 2025
Humana
Associate / Product Owner - Marketing Resource Management (MRM)
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first Humana is evolving its marketing operations to enable smarter planning, faster execution, and greater transparency-and we're looking for a product manager to lead that effort. As Senior Associate/Product Manager - Marketing Resource Management (MRM) Capabilities, you'll own the roadmap for tools and workflows that support campaign intake, planning, approvals, and performance tracking. This role is central to enabling scalable, compliant, and insight-driven marketing operations. You'll help guide the transition to a modern resource management platform and evaluate opportunities to integrate with enterprise workflow systems to support intelligent orchestration. This role supports the day-to-day configuration and optimization of marketing resource management tools and workflows. You'll work closely with cross-functional teams-including Marketing, Creative, Legal, and IT-to ensure campaign planning and...

Dec 14, 2025
Humana
Senior Workforce Management Professional
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Senior Workforce Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Forecasting Analyst plays a pivotal role in shaping strategic workforce planning through advanced forecasting methodologies, comprehensive data analysis, and insightful consultation. This position is responsible for overseeing and refining staffing forecasts, optimizing resource allocation for contact center and back-office operations, and driving continuous improvement in workforce management...

Dec 13, 2025
Humana
Lead Product Owner - Product Management
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Lead Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and complexity ranging from moderate to substantial. This role will be aligned to Humana sales technology platforms, helping further advance capabilities that provide a seamless...

Dec 13, 2025
Humana
Associate Director - Finance Data Management
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first The Associate Director, Finance Data Management supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Finance Data Management requires a solid understanding of how Finance organization data capabilities interrelate across department(s). The Associate Director, Finance Data Management supports implementation of government and industry policies for requirements management, document management, change management, production and delivery, and configuration management of the performance, functional, and physical baselines. Acquires, validates, stores, protects, and processes required data to ensure the accessibility, reliability, and timeliness of the data for its users. Develops and executes architecture, policies, practices and procedures that properly manage the full data lifecycle needs of an enterprise. Decisions are typically related to identifying...

Dec 12, 2025
Humana
Staff Utilization Management Clinical Pharmacist
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Dec 07, 2025
Humana
Lead Product & Strategy Manager - Provider Practice Management
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team within Clinical Strategy and Analytics. This role is not a traditional software product manager role. Instead, it requires demonstrated expertise in healthcare delivery, provider performance improvement, operational redesign, and translating insights into actionable workflows for clinical practices. The Lead Product & Strategy Manager will work across clinical initiatives focused on reducing 30-day Plan All-Cause Readmissions (PCR). They will partner closely with high-performing and low-performing provider groups to identify clinical best practices, understand operational gaps, and design and...

Dec 07, 2025
WayUp
Digital Strategist / Change Management (Adobe Practice)
WayUp Jefferson City, MO, USA
We are seeking a dynamic and strategic Digital Strategist / Change Management to lead clients through the change management lifecycle as part of value realization engagements. This role is pivotal in enabling marketing organizations to unlock growth, improve performance, and accelerate digital transformation by aligning people, processes, and platforms. You'll partner with executive sponsors and product owners to activate prioritized use cases, accelerate adoption, and institutionalize new ways of working. Key Responsibilities: Change Management & Enablement Lead stakeholder mapping, sponsorship models, and governance; run change impact assessments and readiness plans. Design and deliver enablement (role-based training, playbooks, office hours) for marketers, analysts, data engineers, and journey designers. Orchestrate communication plans and feedback loops to sustain adoption and continuously improve ways of working. Operating Model &...

Dec 06, 2025
Highmark Health
Medical Director, Medical Management
Highmark Health Jefferson City, MO, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members...

Nov 26, 2025
Humana
Actuary, Medicaid Trend Analytics and Data Management
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to support modeling, reporting, and decision-making. Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results. Lead and manage data-related projects from scoping through post-production validation, partnering with teammates to implement data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with actuarial, financial, and clinical teams to assess and determine optimal data solutions. Provide strategic recommendations on data architecture and improvements. Support team in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary,...

Nov 24, 2025
Humana
Investment Management Principal
Humana Jefferson City, MO, USA
Become a part of our caring community and help us put health first The Investment Management Principal analyzes investments, primarily debt securities, and recommends appropriate investments. May assist in the development and maintaining of relationships with internal and external business partners including asset managers and banks. May prepare reports on investment transactions and status. The Investment Management Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Investment Management Principal assists in the development and maintaining of relationships with internal and external business partners including asset managers and banks. Prepares reports on investment transactions and status. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs or functions and provides recommendations to senior executives on...

Nov 22, 2025
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