- Molina Healthcare (Miami, FL)
- …+ Policy & Procedures **PREFERRED QUALIFICATIONS:** + BA/BS and/or CHC (Certified in Healthcare Compliance ) To all current Molina employees: If you are ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare 's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a… more
- Humana (Tallahassee, FL)
- … auditing experience + Ability to analyze large data sets + Knowledge of healthcare compliance , mainly primary care and risk adjustment, pharmacy knowledge a ... conducts compliance related audits to assess internal controls, examining healthcare records and processes, and analyzing and reporting risks. + Influence… more
- Highmark Health (Tallahassee, FL)
- … Program including auditing/monitoring operational processes, conducting or overseeing compliance investigations , and ensuring that adequate training takes ... to internal and external audit progress, recurring risk and compliance reporting, mandated training, investigations , and the...risk, audit, or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES or CERTIFICATIONS**… more
- Molina Healthcare (St. Petersburg, FL)
- …Advantage or Medicaid programs + Awareness of CMS audit processes or healthcare compliance requirements **Ideal Candidate Attributes** + **Curious and Eager ... opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and cross-functional collaboration. Success in this role… more
- Cardinal Health (Tallahassee, FL)
- …E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles and techniques; CMS ... adherence to policies, educates and trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. Ethics & … more
- AdventHealth (Altamonte Springs, FL)
- …regional activities to identify and address regulatory risks in the areas of healthcare compliance and privacy. Investigate and respond to identified and/or ... as a subject matter expert supporting staff and leaders on areas of regulatory healthcare compliance including, but not limited to: general compliance ,… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …(A/E) and Construction contracts to ensure the contractor is in compliance with all contractual requirements, healthcare regulations and codes, ... relevant codes, regulations, guidelines and standards to make recommendations to assure compliance with healthcare facility programs. Ability to understand the… more
- Veterans Affairs, Veterans Health Administration (Pensacola, FL)
- …relevant codes, regulations, guidelines and standards to make recommendations to assure compliance with healthcare facility programs. Ability to understand the ... a Project Engineer at an assigned Department of Veterans Affairs (VA) Healthcare System. This position performs project planning, produces designs, manages designs,… more
- Community Health Systems (Naples, FL)
- …Professional in Healthcare Risk Management (CPHRM) and/or Certified in Healthcare Compliance (CHC) **(required)** + Master's Degree or related certification ... key leader responsible for overseeing risk management, patient safety, and regulatory compliance across Physicians Regional Healthcare System. This role ensures … more
- CVS Health (Tallahassee, FL)
- …2 years or more previous experience with medical record review within a healthcare insurance company. - Prior special investigation unit experience. - Excellent ... Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical,… more