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Job Title Service Laboratory Supervisor Requisition Number RE52843 Working Title Department Name 81240:REGULATORY SERVICES Work Location Lexington, KY Grade Level 44 Salary Range $43,805-70,075/year Type of Position Staff Position Time Status Full-Time Required Education BS Click here for more information about equivalencies: <a href="https://hr.uky.edu/employment/working-uk/equivalencies" target="_blank">https://hr.uky.edu/employment/working-uk/equivalencies</a> Required Related Experience 3 yrs Required License/Registration/Certification None Physical Requirements Sitting for long periods of time, and good eyesight. Shift Primarily days. Job Summary The Martin-Gatton College of Agriculture, Food and Environment Division of Regulatory Services seeks a Service Lab Supervisor. This position provides supervision of analytical staff for mandated seed testing facility including all germination and purity testing activities, which contributes to the tripartite (research, service, and education) unit mission. Ensures accurate and timely seed quality analysis for regulatory program, producers, agribusiness firms, researchers and others based on scientific principles and common sense. The Martin-Gatton College of Agriculture, Food and Environment is a welcoming workplace that offers a variety of employee enhancement initiatives, such as a formal mentoring program and a staff professional development fund. To find out more about M-G CAFE and how the college supports the mission of this being the University of, for, and with Kentucky, Click Here Skills / Knowledge / Abilities Basic keyboarding &amp; software familiarity. Manual dexterity/adequate vision critical. Does this position have supervisory responsibilities? Yes Preferred Education/Experience Work toward and obtain necessary certification(s) to maintain voting member status with AOSA. Deadline to Apply 01/25/2026 Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Service Laboratory Supervisor

Job Title Custodial Supervisor Requisition Number RE52887 Working Title Department Name 3CP02:Phys Plt-Custodial Services Work Location Lexington, KY Grade Level 41 Salary Range $15.83-25.30/hour Type of Position Staff Position Time Status Full-Time Required Education HS Click here for more information about equivalencies: <a href="https://hr.uky.edu/employment/working-uk/equivalencies" target="_blank">https://hr.uky.edu/employment/working-uk/equivalencies</a> Required Related Experience 4 yrs Required License/Registration/Certification None Physical Requirements Lifting, pushing, and/or pulling objects up to and possibly over 50lbs; Standing or walking with objects up to 25lbs; Sitting at computer workstation for extended periods; Repetitive motion. While some work is done in an office, frequently work is out in the field overseeing zone locations and may be exposed to elements, weather, and other non-office type conditions. Shift 5:30am – 2:15pm; (Monday-Friday). 2:00pm – 10:30pm; (Monday-Friday). 9:30pm – 6:00am; (Monday-Friday). 3:30am – 12:00 noon; (Monday-Friday). Hours of work may vary dependent upon situational factors and may include some nights(s), weekend(s), and holiday(s) response. Job Summary The Custodial Supervisor: <ul><li>oversees daily custodial services requirements provided within assigned zone area(s)</li><li>reviews any changes (new and/or temporary) regarding custodial services requirements with respective customers and department management</li><li>ensures custodial services are completed in an accurate, efficient, and timely manner</li><li>serves as point of contact between customers, staff, and vendors</li><li>troubleshoots service issues as necessary and implements solutions</li><li>stays informed of current technology trends and learns new technologies as they are developed</li><li>strives for continuous improvement in all activities and work performance</li></ul> In addition, this position: <ul><li>directly supervises assigned custodial personnel</li><li>maintains appropriate staffing levels</li><li>focuses on relationships among team members and customers</li><li>addresses employee relations issues, and initiates corrective actions</li><li>conducts individual performance evaluations</li><li>prepares and implements training and development plans</li><li>proactively assists direct reports in reaching and obtaining their goals and objectives</li><li>promotes teamwork and a positive work environment</li></ul> Skills / Knowledge / Abilities MS Windows/Office;KRONOS;SAP Does this position have supervisory responsibilities? Yes Preferred Education/Experience HS + 4 Driver’s License — Preferred Deadline to Apply 02/08/2026 Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Custodial Supervisor

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Manager, Category Management and Procurement manages and leads the development and execution of multi-year category strategies and implementation of the overall category management and procurement processes for multiple categories and commodities. This position manages continuous improvement and governance of the L.A. Care source-to-pay process. The Manager works closely with key stakeholders and cross-functional teams in developing and executing category plans, strategic sourcing events, supplier performance management (scorecards/quarterly business reviews).The Manager is an expert on all category management, procurement, and relationship management requirements and processes.&nbsp; The position leads and provides consultation to other cross-functional teams with executing cost reduction and related activities across the enterprise. The Manager ensures that the team's collective efforts deliver measurable value (savings, cost avoidance, risk reduction, and service improvements), reduce request for proposal (RFP) and contract cycle time, and increase customer service in support of optimizing L.A. Care operations. This position interfaces with internal and external stakeholders.&nbsp;This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; The Manager also stewards adherence to procurement policy, contracting standards, and audit readiness across assigned categories. Participates and makes recommendation on the department's strategic planning and/or long-term decision-making.<h4>Duties</h4>Manages and leads the overall category management and procurement process to ensure high-value execution and integrity of all vendor relationships, pricing and contracts within L.A. Care source-to-pay. Oversees the development and execution of category strategies that align with organizational priorities and deliver measurable savings, efficiency, and compliance. Leverages and optimizes source-to-pay (S2P) systems to improve transparency, accuracy, and cycle time. Ensures vendor data integrity, pricing accuracy, and timely contract execution. Develops requirements, reports, and staff training that reinforce continuous improvement and effective use of procurement systems.Manage and develops staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others. Ensures staff are proficient in category management methodologies, procurement policies, and S2P tools. Provides guidance, feedback, and escalation support to enable effective decision-making and issue resolution. Responsible for reporting, budgeting, and policy implementation.Manages complex, cross-functional sourcing and contracting projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Leads Vendor Selection Process/Request for x (RFxs) and negotiations on select high value vendor contracts from cross-functional teams and provides consultative expertise to the team on other vendor RFxs. Ensures documentation, evaluation criteria and award decisions are compliant, transparent and aligned with L.A. Care standards.<h4>Duties Continued</h4>Plans, implements and refines systems and procedures to maximize operating efficiency and achieve strategic priorities.<h4>Acts as a subject matter expert (SME) for cross-functional teams on proper category management and procurement execution that balances risks and flexibility.&nbsp; Ensures end-to-end source-to-pay process complies to L.A. Care policies while incorporating best practice for effectiveness, efficiency, and better customer service. Implements end-to-end category management and procurement procedures that are compliant to L.A. Care policies and meet L.A. Care's objectives. Ensures category management and procurement procedures and training materials complement procurement processes.&nbsp; Drives continuous process improvement, automation and adoption of best-practice sourcing governance.</h4><h4>Partners with internal departments to develop effective contract processes, tools, and standard procedures while leveraging the contract management system to its fully extent possible. Responsible for safeguarding the acceptable contract clauses, language, templates, and tools pre-approved by the legal team. Collaborates with key stakeholders to manage risk, maintain compliance and improve contract quality and turnaround time.</h4><h4>Leads and facilitates formal meetings with senior internal staff in developing strategic and tactical plans for category management, vendor relationship management, savings opportunities and/or RFx/contracting strategies that allow L.A. Care to function more effectively. Performs vendor contract inventory analysis and reporting, including contracts expirations, spend and compliance data, for review.&nbsp; These insights inform category plans, sourcing pipelines and vendor consolidation opportunities to strengthen vendor performance and ensure ongoing contract compliance. Performs other duties as assigned.</h4><h4>Education Required</h4>Bachelor's Degree in Business or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business or Related Field<h4>Experience</h4>Required:At least 6 years of relevant experience managing the full contract lifecycle for service-related categories and commodities.At least 4 years of experience in leading, supervising, and/ or managing staff, whether directly or indirectly.Experience drafting, negotiating, red lining, finalizing and managing complex supplier agreements for a wide variety of goods and services.<h4>Skills</h4>Required:Strong legal and business acumen with demonstrated ability to manage complex negotiations and relationships.&nbsp;Excellent written and verbal communication and presentation skills to secure most favorable terms, prices and/services levels and contract terms.&nbsp;Ability to provide direction to team members to execute category management, procurement, and contract efforts with outside vendors.&nbsp;Ability to negotiate and manage relationships and contracts with outside vendors that are in the best interests of L.A. Care.&nbsp;Tactful, diplomatic in implementing new processes, procedures, and systems across L.A. Care and ability to convince staff and management why changes are needed. Skilled in driving and integrating organizational change across all levels.&nbsp;Must be proactive, resourceful, and able to find alternative solutions to deliver results.&nbsp;Demonstrated ability to communicate, problem solve, and work effectively with business, procurement and legal professionals.&nbsp;Ability to be consultative to internal stakeholders on developing the best category management and strategic sourcing (including contract) options.&nbsp;Excellent organizational skills with the ability to manage multiple projects.&nbsp;Strong internal stakeholder management skills: capacity to listen, build trusting relationships in all levels of the organization, understand and capture stakeholder's needs and deliver effective solutions.&nbsp;Good knowledge of legal environment related to purchasing contracts and framework agreements.&nbsp;Strong analytical skills, with keen understanding of relevant cost drivers.&nbsp;Demonstrated ability to select, manage, develop and coach others.&nbsp;Persuasion Skills: Effective negotiator who exhibits high levels of personal integrity and honesty. Skills in planning and coordinating vendor visits and negotiations, and comprehensive knowledge of market conditions. Understanding of the flow and accounting requirements to facilitate document flow and efficiency. Ability to enforce policy compliance.&nbsp;Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.&nbsp;Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.&nbsp;Skilled in mediating disputes and resolving conflicts in a fair and constructive manner. Must have a deep understanding of financial principles.&nbsp;Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.&nbsp;Demonstrated ability to make informed decisions.&nbsp;Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges. Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Financial Impact: Effective vendor contract negotiation will have a high financial impact and influence because of negotiation of pricing and contract terms.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Relationship Manager, Performance Management, Customer Service, Human Resources

L.A. Care Health Plan

Manager, Category Management and Procurement

Salary Range:&nbsp;&nbsp;$171,925.00&nbsp;(Min.) -&nbsp;$232,100.00&nbsp;(Mid.) -&nbsp;$292,274.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Director, Core Administrative Operations is responsible for leading and optimizing L.A. Care’s core administrative functions, including Claims Administration, Payment Integrity, Configuration, Electronic Dara Interchange (EDI) and Quality Assurance. This leader ensures standardized, efficient, accurate, and compliant administrative operations that support high-quality service to providers, members, and internal business partners.Steers top-level decision-making and implement initiatives that drive organization's forward. This role drives modernization, operational maturity, and continuous improvement across all core administrative operations, grounded in clear performance expectations, strong governance, and measurable outcomes. The Senior Director collaborates closely with cross functional teams to ensure effective alignment, operational readiness, and sustained performance The Senior Director will oversee a diverse team, ensuring talent development, performance management, and a culture of accountability and operational excellence.This position is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Develops strategic plans, drives change and influences critical business outcomes.<h4>Duties</h4>Translates strategy into disciplined operational execution. &nbsp;Sets clear expectations, drives cross-functional alignment, and ensures that teams have the tools, data, and governance needed to operate effectively. Collaborates across multiple administrative functions, ensuring workflows, technical changes, performance indicators, and regulatory requirements are understood, synchronized, and executed consistently. Anticipates operational challenges, removes barriers, and strengthens end-to-end processes. &nbsp;Collaborates, plans, proactively problem-solves, leads with transparency, accountability, and focuses on continuous improvement. &nbsp;Elevates operational reliability and positions the organization for sustained success as systems, products, and regulatory standards evolve.Leads strategy, operations, and modernization across service areas accuracy, efficiency, and strong control environments. Establishes and manages operational goals, key performance indicators (KPIs)/objectives and key results (OKRs), dashboards, and other metrics to transparently drive consistent performance and compliance.Develops and implements standardized workflows, governance structures, and operating procedures.Fosters a culture of proactive issue identification, cross-functional communication, accountability, transparency, and continuous operational improvement.Directs EDI operations supporting claims submissions, remittance transactions, provider and member exchanges, and other electronic transactions.&nbsp; Drives automation, data accuracy, and improved electronic submission performance. Oversees monitoring and timely resolution of technical issues, rejections, and systemic defects.Ensures high-quality adjudication with strong accuracy, first-pass rates, correct benefit application, and compliance with DHCS, DMHC, CMS, Covered California, and NCQA requirement. Oversees configuration of benefits, reimbursement logic, pricing methodologies, and adjudication controls.<h4>Duties Continued</h4>Collaborates with key stakeholders on prioritization, execution, and validation of configuration updates, system enhancements, and benefit launches.Leads strategy and operations related to pre-pay controls, cost-avoidance, post-pay recovery, clinical editing, coordination of benefits (COB), overpayments, and third-party liability (TPL)/subrogation.&nbsp; Partners with cross functional teams to support fraud mitigation and compliance with state and federal requirements.&nbsp; Improves financial accuracy and reduces inappropriate payments through robust controls and audit-ready processes.Oversees QA programs across all Core Administrative Operations to ensure ongoing accuracy and compliance.&nbsp; Strengthens control environments through audits, desktop and other standard operating procedures, and performance monitoring.&nbsp; Partners with Compliance, Internal Audit, and Enterprise Risk Management on CAPs, audit responses, remediation plans, and sustainability efforts.Oversees the performance of operational vendors in assigned areas. Ensures compliance with service level agreements (SLAs), audit standards, quality expectations, and contractual obligations. Evaluates vendor performance and ensures the implementation of improvements.Develops goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees.Manages budgets and resources effectively. Conducts strategic planning to utilize resources in order to meet current and future departmental and Enterprise-wide goals.&nbsp; Identifies and actualizes enhancements to support company vision. &nbsp;Identifies and drives change initiatives.Collaborates with cross-functional teams to achieve common goals. &nbsp;Leads discussions on policy operationalization and oversees key policy perspective sharing. &nbsp;Represents the company or organization in external interactions. &nbsp;Develops and maintains relationships with key stakeholders.Develops and implements communication strategies.Performs other duties as assigned.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 9 years of progressively responsible experience leading large operational teams and multi-functional departments in managed care operations, including Claims Administration, Payment Integrity, Configuration, or similar functionsAt least 8 years of management/supervisory experience.At least 5 years of experience with Payment Integrity operations.At least 5 years of experience with claims system configuration, technical changes, and operational readiness for products, benefits, and system updates.Demonstrated successful experience improving operational accuracy, reducing inappropriate payments, and driving regulatory compliance.At least 5 years of experience supporting regulatory audits.Preferred:Experience in government-sponsored programs and large regional plans.Experience with vendor management.<h4>Skills</h4>Required:Strong interpersonal leadership skills and an ability to motivate and develop talent while driving accountability.Expert knowledge of managed care administrative operations. Strong strategic, analytical, and financial skills, including the ability to interpret trends, assess risk, and evaluate cost-avoidance opportunities.Deep understanding of regulatory requirements for Medicaid (Medi-Cal), Medicare, Marketplace, and commercial lines of business.Proven ability to lead in complex, high-volume, highly regulated environments with competing priorities.Exceptional communication and stakeholder management skills, with the ability to translate complex concepts into actionable plans. Exceptional leadership skills and abilities, with demonstrated ability to manage, mentor, and develop multi-level teams.Ability to design and implement standardized processes, governance models, and operational controls.Strong skills with claims platforms and analytics/reporting tools.Proficient with Microsoft Office and data/reporting tools.High level of organization, planning, prioritization and attention to detail.Demonstrated ability to think long-term and develop strategies that align with the overall goals of the organization.Demonstrated ability to make sound and timely decisions.Demonstrated ability to adapt to changing situations and adjust strategies accordinglyDemonstrated ability to adapt to a fast-paced and evolving environment and to lead others through change.Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environmentExcellent ability and knowledge in analyzing data, identifying problems, and making informed decisions, often in complex or ambiguous situations.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Lean Six Sigma Green BeltLean Six Sigma Black Belt<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Internal Audit, Claims, Medicaid, Medicare, Risk Management, Finance, Insurance, Healthcare

Senior Director, Core Administrative Operations

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Manager, Payment Integrity (PI) Operations, manages and leads critical components of L.A. Care’s enterprise Payment Integrity program, overseeing the design, execution, and continuous refinement of pre-payment and post-payment accuracy activities. This position integrates operational management with analytic, regulatory, and contract-driven development to prevent inappropriate payments, strengthen upstream controls, and ensure accurate financial outcomes across all lines of business.The Senior Manager manages multi-functional teams responsible for prospective edit development, clinical and non-clinical pre-payment reviews, retrospective audits, overpayment/underpayment identification, recovery operations, and pipeline management. This position ensures PI programs are executed consistently, documented clearly, and aligned with regulatory, contractual, and financial expectations.The Senior Manager works closely with cross-functional stakeholders to translate insights into actionable system changes and preventive modifications. The Senior Manager serves as the operational driver for Payment Integrity interventions, ensuring programs scale effectively, are audit-ready, and deliver measurable reductions in inaccurate or wasteful spend.Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.&nbsp; Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.<h4>Duties</h4>Leads daily operations of pre-pay and post-pay PI activities, ensuring accuracy, timeliness, and effective case management. Oversees prospective review programs including clinical editing, code auditing, algorithm-driven controls, and provider contract/benefit interpretation. Ensures post-pay functions, including data mining, recovery validation, provider outreach, and reconciliation, are accurate, transparent, and compliant. Establishes standardized workflows, documentation, and quality review expectations across all PI teams. Ensures Payment Integrity operates as a disciplined, analytically driven, and preventive control function.Strengthens the reliability of claims processing, increases automation and cost avoidance, manages complex PI workflows, and translates regulatory and contract-driven requirements into systematic, sustainable accuracy improvements.Oversees development, refinement, and implementation of new edits, rules, and clinical/non-clinical logic that reduce future payment errors. Translates regulatory updates, provider contract terms, benefit changes, and emerging industry standards into edit or algorithm recommendations. Manages the PI pipeline of prospective initiatives, ensuring strong prioritization, impact modeling, and timely deployment. Partners with key stakeholders to implement upstream corrections and reduce recurring defects. Ensures prospective controls improve auto-adjudication, accuracy, and reduction of rework.Oversees identification and validation of overpayments and underpayments from solicited/unsolicited sources, analytics, and vendor partners. Ensures recoveries follow compliant workflows, including provider notification, appeal support, repayment management, and financial reconciliation. Ensures post-pay insights translate into upstream corrective actions, edit changes, or preventive improvements. Oversees development of operational processes that strengthen coordination between internal recovery teams and external vendors.Directs analytic and data mining efforts to detect billing anomalies, emerging risk patterns, and high-impact cost avoidance opportunities. Partners with enterprise analytics to refine predictive modeling, trending dashboards, and reporting frameworks. Ensures analytical findings convert into operational interventions, policy updates, or system changes. Identifies high-risk providers, services, or claims behaviors requiring new controls or deeper review.<h4>Duties Continued</h4>Ensures PI programs align with federal, state, and contractual requirements for all lines of business. Interprets regulatory updates and directs teams to integrate changes into rules, workflows, and edit development. Ensures that benefit structures, contract terms, and pricing methodologies are correctly reflected in both pre- and post-pay activities. Partners with Compliance and SIU on cases requiring heightened review or escalated investigation.Oversees operational execution of vendor-driven PI programs, ensuring strong Service level agreement (SLA) performance, validated results, and accurate financial reporting. Supports vendor onboarding, implementation, testing, and algorithm or rule customizations. Ensures internal teams coordinate effectively with external partners across pre-pay and post-pay programs.Partners with cross-functional key stakeholders to resolve system issues and strengthen upstream accuracy. Serves as an advisor to internal partners on PI trends, risk areas, provider behavior insights, and recommended control changes. Ensures PI findings are shared proactively and used to influence broader operational and configuration improvements.Manages staff and the day-to-day activities in the department. Participates in the department budgeting process.&nbsp; Responsible for scheduling, training, performance, corrective actions, mentoring, developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and problem-solving skills across the team.Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.Responsible for overseeing and managing the budgets of their respective departments.Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.Perform other duties as assigned.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:&nbsp; At least 6 years of Payment Integrity, Program Integrity, medical cost containment, Fraud Waste and Abuse (FWA), data mining, claim accuracy, or related experience.At least 5 years of experience in leading staff, Supervising and/or managing staff.Experience leading teams, projects, initiatives, and cross-functional groups.Experience in Medicaid, Medicare, and Commercial managed care lines of business.Experience in pre-pay and/or post-pay review, edit development, recovery operations, or claim logic development.Experience interpreting provider contracts, payment methodologies, and managed care benefit structures.Experience handling complex claim review, root-cause evaluation, and adhering to regulatory TAT requirementsExperience working with COB and Third-Party Liability (TPL) claims in a managed care setting.Experience with vendor-managed PI programs.Preferred:Experience applying predictive analytics or algorithm-based PI solutions.Experience with SQL, BI tools, or data mining platforms.<h4>Skills</h4>Required:Strong understanding of adjudication, coding, and the application of Division of Financial Responsibility (DOFR) to claims processing.Extensive knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD)-10, DRG/ Ambulatory Payment Classification (APC), and pricing methodologies.Understanding of benefit interpretation, contract terms, and payment rules.Strong analytical, investigative, financial, and operational skills.Exceptional written and verbal communication skills, including executive communication and the ability to translate technical findings into actionable recommendations.Advanced project leadership, workflow management, and prioritization skills.Ability to collaborate with internal and external stakeholders at all levels.Proven problem-solving skills and ability to translate knowledge to the department.Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.Must have a deep understanding of financial principles.Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.Demonstrated ability to make informed decisions.Strong verbal, written communication and presentation skills.Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.Preferred:Knowledge of SIU/FWA methodologies and risk indicators.Experience with SQL, BI tools, or data mining platforms.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certified Professional Coder (CPC) designation by the American Academy of Professional Coders<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Medical Coding, Claims, Medicare, Medicaid, Healthcare, Insurance

Senior Manager, Payment Integrity Operations

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Manager, Electronic Data Interchange (EDI) &amp; Data Operations is responsible for leading and optimizing the day-to-day operational, analytical, and technical functions that support electronic data exchange, authorization data ingestion, accumulator management, and Explanation of Benefits (EOB) processing for L.A. Care. This includes operational oversight of all Health Insurance Portability and Accountability Act (HIPAA) standard and proprietary EDI transactions, delegated and internal authorization data loads, accumulator workflows, and the operational components of EOB generation and remediation.The Senior Manager oversees a team who manage file intake, data validation, routing, reconciliation, testing, and issue resolution across the enterprise. This position ensures that all electronic and paper-to-electronic data supporting claims and administrative operations is accurate, timely, and compliant with regulatory, contractual, and quality expectations.This position plays a critical leadership role in enhancing upstream controls, reducing rework, improving automation, supporting system changes, and driving continuous improvement in data operations.Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.&nbsp; Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.<h4>Duties</h4>Strengthens the reliability, accuracy, and efficiency of all electronic data processes that support claims operations, ensuring data flows through systems as intended, issues are rapidly identified and remediated, and upstream controls are continuously enhanced. Helps drive predictable outcomes, improve payment accuracy, and maintain regulatory readiness across the data ecosystem.Manages end-to-end operational oversight of all inbound and outbound HIPAA-standard and proprietary EDI transactions (837, 835, 270/271, 276/277, 834, 278). Ensures timely, accurate, and compliant processing of electronic claims, encounters, eligibility updates, and related administrative data.Oversees transaction monitoring, exceptions, error queues, and data rejects; ensures prompt triage and resolution. Provides oversight of requirements documentation, including business and functional requirements (BRDs/FRDs), workflow mapping, and data specifications that support operational effectiveness.Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.&nbsp;Leads oversight of delegated Electronic Load of Delegated Authorizations (ELDA) and internal clinical authorization data loads into QNXT. Ensures authorization data is timely, complete, reconciled, and supportive of accurate claims adjudication.Monitors authorization load success rates and partners with upstream teams to resolve recurring issues. Guides enhancements that reduce manual lookup burden for claims and increase automation.Manages operational components of the Member Out-of-Pocket (MOOP) accumulator workflow, including reconciliation, error correction, escalation management, and member remediation.Ensures accumulator data is accurate across intake systems, accumulator databases, QNXT, and output files.Provides reporting and trending on accumulator performance, error patterns, and upstream causes.Shares responsibility with the Director, EDI for operational oversight of EOB generation, validation, and data flow.Ensures EOB output files reflect accurate benefit application, share of cost, accumulation, claim decisions, and meets regulatory requirements. Troubleshoots and resolves EOB-related issues, including cost-share miscalculations, missing data, formatting discrepancies, and system defects. Supports testing of EOB templates, logic updates, and system enhancements that impact EOB accuracy and delivery.Leads complex root cause analyses for issues impacting claims data, authorizations, accumulators, or EOBs.<h4>Duties Continued</h4>Coordinates remediation efforts with cross-functional departments. Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.Ensures corrective actions are documented, validated, and monitored to prevent recurrence. Identifies systemic issues and recommends upstream solutions to strengthen operational controls and improve accuracy.Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Leads process and workflow redesign efforts to increase automation, reduce manual work, and improve overall data quality.Oversees User Acceptance Testing (UAT) planning, test case creation, execution, and validation for system changes affecting EDI, authorization data, accumulators, and EOBs.Ensures strong quality gates are consistently applied before production releases.Works closely with the Director, EDI to prioritize enhancements and support operational readiness for system changes.Serves as an operational liaison to cross-functional departments and delegated entities.Communicates system availability, planned changes, incident statuses, and file processing updates clearly and consistently.Supports internal and external partners with non-standard data requests, testing analysis, and troubleshooting.Manages staff and the day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and critical thinking skills across the team. Responsible for overseeing and managing the budgets of their respective departments.Maintains a culture of rigor, transparency, analytical curiosity, proactive issue identification, cross-functional communication, accountability, and continuous operational improvement.Perform other duties as assigned.&nbsp;<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 6 years of experience working with healthcare data, EDI transactions, claims data operations, or managed-care administrative systems.At least 5years of experience in leading, supervising and/or managing staff.Experience with system integrations, data migrations, or large-scale technical implementations.Demonstrated experience leading complex issue resolution and root cause analysis efforts.Experience leading teams, projects, initiatives, or cross-functional groupsPreferred:Experience developing test cases, leading UAT, or supporting system configuration changes.Experience with commercial health plan operations or delegated partner management.<h4>Skills</h4>Required:Strong knowledge of HIPAA-standard EDI transactions and healthcare data structures.Knowledge of MOOP accumulators, authorization workflows, and EOB data flows.Familiarity with claims adjudication rules, cost-share logic, and benefit application.Proficiency in SQL, Access, Excel, and related reporting or analysis tools.Ability to interpret and produce BRDs, FRDs, process flows, and technical documentation.Strong analytical, problem-solving, and system-thinking skills.Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.Excellent attention to detail and ability to manage multiple priorities and tight deadlines.Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.Ability to develop and manage budgets, forecast future financial outcomes, and make informed decisions about resource allocation.Demonstrated ability to make informed decisions.Excellent verbal, written communication, and presentation skills.Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.Strong ability to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.Preferred:Working knowledge of relational databases, system interfaces, or data transformation logic.Experience with delegated entity data submissions or clearinghouse integrations.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Claims, Insurance

Senior Manager, Electronic Data Interchange and Claims Data Operations

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Manager, Clinical and Regulatory Operations, is responsible for leading clinical case operations, regulatory interpretation, and clinical decision stewardship across all grievance, appeal, and State Fair Hearing cases. This position ensures that clinical and non-clinical case handling meets medical necessity standards, regulatory requirements, internal policy expectations, and quality-of-care obligations across all product lines, including Medi-Cal, Medicare, Marketplace, and delegated entities.The Senior Manager oversees clinical operations teams responsible for medical necessity reviews, clinical grievances and appeals, Quality of Care (QOC) referrals, clinician coordination, clinical documentation quality, and regulatory interpretation. The role ensures strong collaboration with Utilization Management, the UM Medical Director, physician reviewers, Compliance, Member Services, Provider Network Management, claims teams, and the Center of Quality &amp; Excellence to support compliant, timely, and high-quality case handling.The Senior Manager manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.&nbsp; Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.<h4>Duties</h4>Oversees end-to-end clinical case handling, including clinical grievances, clinical appeals, medical necessity review coordination, and clinical case triage and ensures consistent application of evidence-based guidelines, clinical criteria, and regulatory standards in all clinical decisions. Partners with the clinical leadership to ensure clinical decision accuracy and appropriateness. Translates clinical guidelines, regulatory requirements, and service standards into operational workflows that ensure accurate, timely, and clinically sound case handling. Ensures clinical documentation is accurate, complete, defensible, and compliant with regulatory expectations.Oversees Quality of Care (QOC) case identification, referral, coordination, and documentation ensuring timely escalation and coordination of complex or medically nuanced grievance and appeal cases.Strengthens the clinical and regulatory integrity of Appeals &amp; Grievances (A&amp;G) operations by guiding staff in the application of medical necessity criteria, ensuring documentation quality, and providing expert regulatory interpretation. Interprets and applies Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), and internal policy requirements related to grievance and appeal processes, ensuring operations maintain regulatory alignment. Serves as a subject-matter expert for regulatory interpretation, providing guidance to operational staff and leadership. Reviews, interprets, and implements regulatory updates that impact clinical or operational grievance and appeal workflows. Partners with Compliance and Legal to resolve regulatory inquiries related to clinical and operational case-handling requirements. Supports creation and revision of clinical and operational policies, SOPs, templates, letters, and decision-support tools.Partners with cross-functional stakeholders to ensure proper handling of clinical and non-clinical cases. Coordinates cross-functional involvement in complex cases, including providers, delegates, plan partners, and medical directors. Supports operational teams in resolving regulatory or clinical issues that arise during case handling.Oversees training and competency development for clinical operations staff, ensuring consistent understanding of medical necessity criteria, regulatory requirements, and decision-making standards. Identifies opportunities to enhance staff capability, accuracy, and regulatory alignment across clinical case-handling processes.Oversees clinical case reporting and trend analysis, identifying patterns in clinical appeals, grievances, and QOC findings. Provides insights to leadership related to clinical drivers of grievances and appeals, opportunities for operational improvements, and service or quality risks.Manages staff and the day-to-day activities in the department. Participates in the department budgeting process.&nbsp; Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and critical thinking skills across the team.Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.Responsible for overseeing and managing the budgets of their respective departments.<h4>Duties Continued</h4>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.&nbsp; Ensures strong clinical judgment, regulatory understanding, and documentation discipline across the team.Builds a culture of rigor, transparency, analytical curiosity, proactive issue identification, cross-functional communication, accountability, transparency, and continuous operational improvement.Perform other duties as assigned.<h4>Education Required</h4>Bachelor's Degree in Nursing or Related Field<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 6 years of experience working in managed care operations, quality assurance, audit readiness, compliance, or related regulatory roles.At least 5 years of experience in leading, supervising and/or managing staff.Experience in Medicaid, Medicare, and Commercial managed care lines of business.Demonstrated experience overseeing quality assurance programs, internal controls, or audit readiness functions within a health plan or similar setting.Strong experience with DHCS, DMHC, CMS, and NCQA requirements related to grievances, appeals, quality-of-care processes, and audit expectations.Experience developing and managing corrective action plans and driving sustainable remediation.Experience collaborating with delegated entities, plan partners, or subcontracted networks.Experience leading teams, projects, initiatives, or cross-functional groups.Preferred:Experience with analytic dashboards and visualization tools (Power BI, Tableau).<h4>Skills</h4>Required:Proven ability to lead universe submissions, mock audits, and regulatory audit responses.Expert knowledge of regulatory requirements, audit processes, and quality assurance practices in managed care.Strong analytical, problem-solving, and critical thinking skills, including ability to translate trends into corrective actions.Ability to design, implement, and sustain standardized processes and internal control structures.Exceptional written and verbal communication skills, including executive communication and the ability to translate trends and other findings into actionable recommendations.Proficiency with Microsoft Office, case management systems, and reporting tools.Strong people skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.Strong attention to detail and ability to manage multiple priorities and tight deadlines.Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.Must have a deep understanding of financial principles.Ability and exceptional knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.Demonstrated ability to make informed decisions.Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call.This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Nursing, Registered Nurse, Medicare, Medicaid, Medical Research, Healthcare

Senior Manager, Clinical and Regulatory Operations

Castle Biosciences Earns "Top Workplaces USA Award" for Phoenix, Pittsburgh, and Friendswood! Learn more at <a href="http://www.CastleBiosciences.com" target="_blank">www.CastleBiosciences.com</a>Castle Biosciences Inc. is growing, and we are looking to hire a full-time Reimbursement, RCM Systems Supervisor working from our Friendswood, Texas, office location, with a start date of February 9, 2026. Why Castle Biosciences?Exceptional Benefits Package:<ul><li>Excellent Annual Salary + 25% Bonus Potential</li><li>20 Accrued PTO Days Annually + 10 Paid Holidays</li><li>401K with 100% Company Match up to 6%</li><li>3 Health Care Plan Options + Company HSA Contribution</li><li>Company Stock Grant Upon Hire</li></ul>A DAY IN THE LIFE OF A RCM Systems SupervisorAs the RCM Systems Support Supervisor, you'll lead the daily operations of the RCM Systems Support and Payer Enrollment teams, ensuring work is completed accurately and on schedule. Your day will involve answering questions, resolving escalations, and guiding staff through system configuration, billing workflows, and payer requirements. You'll assist with configuration changes, workflow design sessions, and thorough regression testing to maintain system continuity. A key part of your role includes supporting nationwide payer enrollment and credentialing activities, troubleshooting documentation issues, and coordinating required submissions. You will collaborate closely with IT, reimbursement leadership, and external partners to address system or processing concerns. Throughout the day, you'll monitor work quality, maintain progress trackers, and communicate updates, risks, or barriers to leadership-helping drive efficient, compliant, and well‑supported revenue cycle operations.REQUIREMENTS<ul><li>Bachelor's degree in computer science or related field is required, and/or equivalent combination of experience and education.</li><li>At least 3 years in revenue cycle systems management, managing /doing billing system configuration changes, maintenance, upgrades, and system testing and documentation.</li><li>At least 3 years of successfully managing processes and people.</li><li>Knowledge of laboratory medical insurance billing requirements and revenue cycle workflow preferred.</li><li>Experience in doing nationwide laboratory payer enrollment and credentialing; commercial payers and Medicaid.</li><li>Intermediate to advanced proficiency in Microsoft Excel, Word, PowerPoint, SharePoint, and Outlook.</li><li>Attention to detail and the ability to manage multiple priorities in a fast-paced ever-changing environment.</li><li>Strong analytical, problem‑solving, and critical‑thinking skills.</li><li>Ability to learn new skills quickly and apply them to daily job responsibilities.</li><li>Experience developing SOPs and process documentation.</li><li>Experience working with clearing houses.</li></ul>*Please see the full job description at the end of the job ad.SCHEDULE<ul><li>Monday - Friday, 8 AM - 5 PM working from our Friendswood, Texas office location. May consider remote candidates</li></ul>READY TO JOIN OUR BIOTECH TEAM?We truly appreciate your time. If this feels like the right opportunity for you, we'd love for you to complete our mobile-friendly application. We're excited to learn more about you and look forward to connecting soon!Castle Biosciences Awards and Research Developments!WORK AUTHORIZATIONAll candidates must be legally authorized to work in the United States. Currently, Castle Biosciences does not sponsor H-1B visas, OPT, or employment-related visas.ABOUT CASTLE BIOSCIENCES INC.At Castle, it all comes down to people. After all, disease doesn't just happen - it happens to people. We believe that disease management and treatment decisions can be better informed through a person's unique biology, which is revealed through the scientific rigor of our innovative, laboratory-developed tests. We are committed to empowering healthcare providers and patients with the goal of improved outcomes. Every employee at Castle has an impact on patient care, and we work to ensure that everyone finds their work to be both challenging and rewarding. We behave with integrity and treat our colleagues with respect and kindness. Our culture fosters an environment of trust, transparency, and collaboration. We prioritize and encourage internal growth and professional development.Castle Biosciences is an equal opportunity employer as to all protected groups, including protected veterans and individuals with disabilities. If you have a disability and you believe you need a reasonable accommodation in order to search for a job opening or to submit an online application, please e-mail <a href="mailto:ReasonableAccommodationsRequest@castlebiosciences.com" target="_blank">ReasonableAccommodationsRequest@castlebiosciences.com</a>.This email was created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.** No third-party recruiters, please

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