- Highmark Health (Pittsburgh, PA)
- …accuracy. Executes audits performed by government agencies (eg, CMS, HHS), internal Compliance and other validation audits to ensure efficacy of documentation, ... and validation of historical member clinical data to fulfill CMS audit requests.Includes retrieval of medical records, validation of member clinical conditions… more
- Centene Corporation (Austin, TX)
- …in mock and actual CMS and other regulatory audits and coordinates with Internal Audit , Regulatory Compliance and/or Market based Regulatory Affairs on responses ... to agency inquiries and oversees the internal and external processes required to ensure the Company...to ensure the Company maintains a consistent state of Audit readiness. + Maintains a current working knowledge of… more
- Genentech (South San Francisco, CA)
- …apply + Drives cross-functional operations for contract strategy implementation compliance and audit + Oversees internal risk monitoring and external audits and ... obligations within legal and regulatory requirements. They oversee critical audit responsibilities for contract operations and support contract management for… more
- Johns Hopkins University (Baltimore, MD)
- The Office of Internal Audit is seeking a **_Sr. Internal Auditor_** that will perform the duties and responsibilities of an Internal Auditor, such as: ... audit constraints and shape priorities. + Negotiate audit parameters with Manager/ Sr. Director . +...understand their individual roles and responsibilities. + Design appropriate internal audit programs and time budgets based… more
- Abbott (Waukegan, IL)
- …as new processes are designed and implemented (Information technology, Internal /external audit , legal, compliance, etc.) **Minimum experience/training required** ... Abbott is a global healthcare leader that helps people live more fully...Chain (SCM) across all organizations associated with these processes, internal and external to BTS/BSS. The incumbent will be… more
- Penn Medicine (Lancaster, PA)
- …and procedures are adhered to consistently. + Works collaboratively with internal audit , compliance, professional billing service, decision support, business ... to ambulatory services. Possess a strong understanding of changes resulting from healthcare reform and its implications on the delivery of and the reimbursement… more
- Geisinger (Danville, PA)
- …interview process conducts interviews and initiates candidate selection. + Partner with internal stakeholders to support product strategy and sales efforts with PI ... data. + Collaborate with internal departments and maintain a dotted-line relationship with PI...for Key Performance Indicators including claim edit and claim audit savings, dollars at risk, overpayment recoveries, referrals, as… more
- Molina Healthcare (Caldwell, ID)
- …and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of management, coordinates and performs ... compliance with Federal and State laws and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, … more
- Globus Medical, Inc. (Audubon, PA)
- …within our dynamic Internal Audit function. This person will work closely with the Internal Audit Director and Internal Audit team in the ... the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture...execution of the board approved internal audit plan. Responsibilities include assisting in… more
- HCA Healthcare (Nashville, TN)
- …you to be a part of our team. **Job Summary and Qualifications** The Internal Audit Department provides an independent appraisal function to validate management ... Compliance Manager RN? At HCA, you come first. HCA Healthcare has committed up to $300 million in programs...personnel to help effect overall compliance. The Clinical Compliance Audit Manager position will work on various audit… more