- Spread Your Wings, LLC. (Garden Grove, CA)
- …requirements when providing services to Intellectualy Disabled Individuals? 2. Do you have Quality Assurance background? 3. Do you have experience or are you ok with ... assigned region. Primary functions will include assessing service delivery, documentation compliance , monitoring of client records, and serving as the representative… more
- General Atomics (Poway, CA)
- …well as advanced high-resolution surveillance systems. We have an exciting opportunity for an Internal Lead Auditor Quality Department located in Poway, CA ... and work instructions. + Evaluate company processes (Business and Quality Systems) for compliance with quality...+ Represents the organization as a primary contact for internal and external audits and corrective action responses. +… more
- Humana (Sacramento, CA)
- …the PCO compliance workplan throughout the year. + Regularly conducts compliance related audits to assess internal controls, examining healthcare records and ... about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and… more
- Intuit (Mountain View, CA)
- …at scale. **What you'll bring** + 3-5 years of experience in SOX compliance , internal audit, external audit, accounting, program/project management, or related ... least 3 days a week. + Strong understanding of internal control over financial reporting, risk assessment, PCAOB expectations...time management skills. + High attention to detail and quality , balanced with the ability to see the big… more
- Centene Corporation (Sacramento, CA)
- …and training to internal and external entities as needed on programs, compliance , and fraud, waste and abuse. + Serve as a Claims regulatory resource related ... to the health plan operations and compliance audits. + Maintain quality and productivity standards set by management. + Adhere to communication which includes… more
- Prime Therapeutics (San Diego, CA)
- …passion and drives every decision we make. **Job Posting Title** Onsite Pharmacy Auditor (based in California) **Job Description** The Onsite Pharmacy Auditor ... of claims, educating Prime's network pharmacies and driving contract compliance , and supporting downstream claim corrections to eliminate potential...+ 2 years of work experience in audit or quality assurance + 1 year of work experience in… more
- CVS Health (Sacramento, CA)
- …education on ICD codes as appropriate + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + ... Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts....mentoring and instruction. + Conducts process audits to ensure compliance with internal policies and procedures as… more
- Sharp HealthCare (San Diego, CA)
- …a key resource for documentation requirements for risk adjustment HCCs, RAF, and/or quality measures. Develop and build relationships with internal and external ... of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and… more
- Highmark Health (Sacramento, CA)
- …Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal , concurrent, prospective and retrospective coding audit activities. Reviews medical ... records to determine data quality and accuracy of coding, billing and documentation related...coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding.… more
- Cherry Bekaert (Los Angeles, CA)
- …practice, we have an excellent opportunity for a **Senior Associate (Consumer Compliance )** to join our team providing internal audit, regulatory ... our clients with deep knowledge, expertise and approaches in Regulatory Compliance , Internal Audit, Enterprise Risk Management, Technology Risk Management,… more