- Molina Healthcare (St. Petersburg, FL)
- …and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of management, performs oversight ... Corporate Compliance , and other key stakeholders, develops and communicates audit scope, objectives, and timelines; Leads development of audit procedures,… more
- Molina Healthcare (Jacksonville, FL)
- …and contributing to initiatives that directly support regulatory and clinical compliance . **Knowledge/Skills/Abilities** + Support RADV audit execution by ... contributing to the end-to-end data strategy and execution of CMS and internal audit activities. This position is responsible for supporting RADV audit cycles… more
- Highmark Health (Tallahassee, FL)
- … operations, risk, audit , or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** ... 7 years in compliance , privacy, government affairs, healthcare operations, risk, audit , or legal functions...(CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified Compliance… more
- Carrington (Jacksonville, FL)
- …from home!** **What you'll do:** Responsible for the timely and accurate response to audit and compliance requests for the enterprise while also ensuring that ... and completeness and reconcile evidence and other assessment documentation to ensure compliance with audit controls and regulatory requirements. + Create and… more
- Molina Healthcare (Jacksonville, FL)
- …**Required Education** Bachelor's Degree or equivalent years of experience in Healthcare Administration such as oversight, audit , etc. **Required Experience** ... and resolve **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to… more
- Molina Healthcare (St. Petersburg, FL)
- …our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing. This role ... Medicaid COB claims for correct secondary pricing logic and compliance with configuration and regulatory rules. + Analyze claim...+ Assist in developing and refining internal SOPs and audit tools related to COB claim reviews. + Act… more
- Carrington (Jacksonville, FL)
- …procedural documents into a complete loan "servicing file" to respond to regulatory compliance audit /exams + Perform assigned compliance testing as assigned ... Analyst I will be responsible for the provisioning documentation for various audit and exam documentation. Also responsible for compliance testing and… more
- Highmark Health (Tallahassee, FL)
- …within task-based budgets.Collaborate and communicate with Information Security, Privacy, Procurement, Audit , Compliance , and other teams across the Enterprise ... fields of study **EXPERIENCE** **Required** + 5 years in Audit and Compliance To Include: + 3...control frameworks, and assessment methodologies, particularly as applied to healthcare (payer and provider) business processes. + Knowledge of… more
- Molina Healthcare (Miami, FL)
- …and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and deliverables are ... met * Evaluate results from audit activities to address barriers, gaps, opportunities for improvement,...implement processes and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services (CMS)… more
- Merck (Tallahassee, FL)
- …, Good Manufacturing Practices (GMP), Inspection Readiness, IS Audit , Management Process, Manufacturing Processes, Pharmaceutical Manufacturing, Quality Improvement ... We are seeking a dynamic and experienced Quality & Compliance Director to lead GMP compliance across...to develop, monitor, and verify CAPA plans addressing global audit and inspection findings, ensuring timely and effective resolution.… more