Jobs in the United States

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Added 3 mins ago
W
(USA) Stocking 1 Coach, Non-Complex
Walmart
BRYANT, AR
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 3 mins ago
W
Food & Consumables Coach
Walmart
BLUFFTON, SC
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Fashion Coach
Walmart
RIVERDALE, GA
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations, utilizing technology, business initiatives, merchandising, and company direction; introducing and leading company…
Added 4 mins ago
W
Coach/Ops Mgr Trainee
Walmart
HORN LAKE, MS
- $31.25 to $38.46 USD / hour
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
SC
(USA) Personal Shopper Lead - Sam's
Sam's Club
WINSTON SALEM, NC
- $22 to $30 USD / hour
…tomanagementSupports the Sams Club ecommerce plan in the club by overseeing operations of the ecommerce programs for example Club Pick Up Ship FromClub etc auditing online customer feedback…
Added 4 mins ago
W
(USA) Stocking 2 Coach
Walmart
PATTERSON, CA
- $71,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Front End Coach
Walmart
MOUNT STERLING, KY
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
IT
SVP of Growth
Inspired Thinking Group (ITG)
Remote, United States
- $240,000 to $280,000 USD / year
…Head of Growth, with a direct line to ITG's global executive leadership and a mandate to build the US business via new client wins. You'll carry the SVP title because the deals are complex,…
Added 4 mins ago
W
(USA) Food & Consumables Coach
Walmart
TERRELL, TX
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Store Manager - Supercenter
Walmart
LEXINGTON, KY
- $110,000 to $170,000 USD / year
…highperformance culture integrating and including Academy associates in leadership and store meetings and activities that supports associateengagement in the overall facility engaging the…
Added 4 mins ago
W
Emerging Store Manager - SC
Walmart
GOLDSBORO, NC
- $85,000 to $120,000 USD / year
This position is a developmental leadership role designed to prepare associates for potential Store Manager opportunities within the Walmart US
Added 4 mins ago
W
(USA) Stocking 2 Coach, Non-Complex, Management
Walmart
DEFIANCE, OH
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Stocking 1 Coach, Non-Complex, Management
Walmart
SAVANNAH, GA
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) GM Coach (Non-Complex) - WM, Management
Walmart
MORGANTOWN, WV
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Maintenance Scheduler, Manufacturing (M-F, 6a-2:30p)
Walmart
OLATHE, KS
- $31.85 to $39.85 USD / hour
Develops daily and weekly maintenance schedules for maintenance and operations teams, using computerized maintenance management systems (CMMS) and other tools to plan plant maintenance…
Added 4 mins ago
W
(USA) Stocking 2 Coach, Non-Complex
Walmart
COMMERCE, MI
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Asset Protection Operations Coach
Walmart
RALEIGH, NC
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 4 mins ago
W
(USA) Coach/Ops Mgr Trainee
Walmart
NASHVILLE, TN
- $31.25 to $38.46 USD / hour
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
W
(USA) GM Coach
Walmart
INDIANAPOLIS, IN
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
W
(USA) Food & Consumables Coach
Walmart
YORK, PA
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
W
Front End Coach
Walmart
SPRINGDALE, AR
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
SC
P_0000242831 (USA) Personal Shopper Lead - Sam's
Sam's Club
PANAMA CITY, FL
- $21 to $29 USD / hour
…tomanagementSupports the Sams Club ecommerce plan in the club by overseeing operations of the ecommerce programs for example Club Pick Up Ship FromClub etc auditing online customer feedback…
Added 5 mins ago
W
Overnight Stocking Coach
Walmart
OZARK, AL
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
W
(USA) Stocking 2 Coach, Non-Complex, Management
Walmart
LIMA, OH
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…
Added 5 mins ago
W
Stocking 2 Coach
Walmart
SULPHUR, OK
- $65,000 to $100,000 USD / year
…collaborating with all levels of associates regarding store operations utilizing technology business initiativesmerchandising and company direction introducing and leading company change…

CommonSpirit Health

Utilization Management Auditor

Rancho Cordova, CA, United States

$39.18 to $58.28 USD / hour

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Job details

Pay: $39.18 to $58.28 USD / hour
Posting language: English
Posted: Aug 19, 2026

Original job description

Job Summary and Responsibilities

As our Senior Compliance Specialist , you will play a critical role in safeguarding organizational integrity by directing the planning, development, and implementation of a comprehensive monitoring and auditing program for contracted health plan operational functions, including utilization management, quality assurance, and network management. You will serve as a vital link between departmental leadership and regulatory bodies, ensuring that all health plan delegation oversight programs are executed with precision to support CommonSpirit Health’s commitment to departmental compliance and excellence.

Every day you will lead the execution of monitoring and auditing plans to assess the compliance of Utilization, Quality, and Network Management departments with Federal and State regulations, including CMS, DMHC, and DHCS requirements, as well as NCQA accreditation standards. Your work involves conducting rigorous reviews of policies, procedures, and case files, while proactively guiding departments through external audits and managing the execution of necessary corrective action plans to mitigate risk and strengthen internal controls.

To be successful in this role, you will leverage your expertise in managed healthcare and HMO operations to provide strategic leadership and business direction. You will act as a subject matter expert, supporting staff education on evolving legal requirements and recommending data-driven improvements to workflows and tools. By fostering collaborative relationships across the organization and representing CommonSpirit Health in industry regulatory collaboratives, you will drive a culture of continuous improvement and ensure sustained adherence to the highest standards of healthcare compliance.

Direct the planning, development, and implementation of a robust monitoring and auditing program for health plan operational functions.
Oversee utilization management, quality, and network management compliance across the organization.
Execute health plan delegation oversight programs to support CommonSpirit Health’s departmental compliance objectives.
Develop and implement audit plans to assess compliance with Federal and State laws, regulations, and accreditation standards.
Guide departments through Health Plan and State audits, ensuring the successful execution of corrective action plans.
Provide leadership and business direction to Corporate Responsibility and Operations teams regarding regulatory requirements.

#Utilization Management, Managed Care, Health Plan Compliance, NCQA, Auditing, Delegation Oversight, CMS Regulations, Data Analysis

Job Requirements

Required

Education: Bachelor’s degree (BSN preferred).
Experience: Minimum five (5) years of experience in managed healthcare/HMO utilization management, program operations compliance, or auditing.
Utilization Management: Minimum three (3) years of specific experience in Utilization Management Auditing.
Regulatory Knowledge: Deep understanding of federal and state laws (CMS, DMHC, DHCS) and NCQA accreditation standards.
Technical Proficiency: Advanced skills in Google Workspace (Docs, Sheets, Slides) and data analysis.
Soft Skills: Strong interpersonal, conflict resolution, analytical, and planning skills with a proven ability to communicate complex information to diverse audiences.

Where You'll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Pay Range

$39.18 - $58.28 /hour

We are an equal opportunity employer.

Apply on usnlx.com About employer

More about this job

Skills

Regulatory compliance
Auditing
Quality assurance
Network administration
Leadership
CMS
Process improvement
Data analysis
Google Workspace
Google Docs
Google Slides
Conflict resolution

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Work requirements

Jobs in the United States