- Molina Healthcare (Yonkers, NY)
- …projects, Risk Adjustment, Risk Adjustment Data Validation, and other state specific audit projects and deliverables. This role also works with the Health Plan ... requirements/rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. + Develops and… more
- Momentive Performance Materials Inc. (Niskayuna, NY)
- Job Title: Global Standards and EHS Compliance Specialist Summary:Reporting to the Sr Manager, Global EHS & Security Systems, this role will be responsible for ... managing International Management Systems, Global EHS standards, and associated compliance audits. This person will act as a technical...Care, and others as necessary), + Lead Global EHS audit program. This includes performing audits, analysis of … more
- Molina Healthcare (Albany, NY)
- …and make decisions as needed while collaborating with other teams. * Ensure compliance with all regulatory audit guidelines by adhering to roadmap of ... deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality through sequential… more
- Datavant (Albany, NY)
- …+ Bachelor's Degree. + 5+ years of experience in a compliance , internal audit , or risk role within the healthcare or technology industry. + Experience ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...healthcare . **Role Summary:** Datavant is seeking a Senior Compliance Analyst to join our dynamic Enterprise Compliance… more
- WMCHealth (Poughkeepsie, NY)
- …Administration, or a related field, preferred. Licenses / Certifications: + Certified in Healthcare Compliance (CHC), required. + Certification in Healthcare ... high risk areas for review and assists the VP, Compliance to prepare the related remedial or audit...regulatory management in a large tertiary academic hospital or healthcare facility, required Education: + Bachelor's degree in Business,… more
- WMCHealth (Valhalla, NY)
- …Administration, or a related field, preferred. Licenses / Certifications: Certified in Healthcare Compliance (CHC), preferred Other: Confidentiality: It is an ... Director of Compliance Company: NorthEast Provider Solutions Inc. City/State: Valhalla,...areas for review and prepares the related remedial or audit plan. + Participates with leadership in identifying and… more
- Capgemini (New York, NY)
- …a **Senior Consultant** in our **Banking** team focused on **Finance, Risk & Compliance ** , you will support the delivery of transformation programs that strengthen ... expertise will help drive value and meaningful improvements in governance, resilience, and compliance . In this role you will: + Support the delivery of client… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and ... necessity/utilization review, and/or other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at… more
- Molina Healthcare (Syracuse, NY)
- …lines of business. This role has decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise ... + Responsible for encounters accuracy & completeness (ie, Encounter Production, Audit , Production Vendor Oversight) for assigned lines of business. Responsible for… more
- Molina Healthcare (Yonkers, NY)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... + Manages Scorable Action Items (SAIs) related to pre-pay editing, post-pay audit , and overpayment recovery initiatives to ensure Health Plan SAI targets are… more