- Cardinal Health (Santa Fe, NM)
- …coders, billers and other appropriate staff. This position will also support the Director with transactional audit diligence and integration planning, as well as ... and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Job Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for ... oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Santa Fe, NM)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Job Summary** The Senior Director of Quality Strategy and Operations will be responsible for developing and delivering the Global Quality strategic plan, ... improvement and governance to areas such as training and audit . Foster a culture of operational excellence, ensuring best...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Rio Rancho, NM)
- …and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of management, coordinates and performs ... and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general development of the Operational Oversight… more
- Genesis Healthcare (Santa Fe, NM)
- …call)! We are seeking a part-time (16-24 hours per week) Attending Physician/Medical Director for our Casa Real Center located in Albuquerque, NM, with potential ... float to nearby centers. This is a Dual Role Attending Physician/Medical Director . It is clinical in nature. Must be BC/BE Internal Medicine or Family Medicine with… more
- Humana (Santa Fe, NM)
- …Compliance team that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This ... mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for… more
- Mass Markets (NM)
- …+ Maintain compliance with internal policies, accounting standards (GAAP/IFRS), and audit requirements. + Monitor and improve accounting processes and systems to ... and external audits by preparing required documentation and responding to audit inquiries. + Collaborate with FP&A, operations, and other cross-functional teams… more
- Molina Healthcare (Roswell, NM)
- …matrix, HEDIS work plans, and all product timelines. + Works with the Director to manage contacts within the plan(s) and/or Molina corporate, external auditors, ... software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and… more
- Molina Healthcare (Las Cruces, NM)
- …+ Responsible for encounters accuracy & completeness (ie, Encounter Production, Audit , Production Vendor Oversight) for assigned lines of business. Responsible for ... Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex… more