• Compliance Specialist

    Sanford Health (Sioux Falls, SD)
    …is managing projects of varying scopes from start to end. Key accountabilities of Health Plan Compliance Department include: * Compliance Policies ... of Communication * Risk Assessment & Work Plans * Compliance Monitoring & Auditing * Mental Health ...dental insurance, vision insurance, life insurance, a 401(k) retirement plan , work/life balance benefits, and a generous time off… more
    Sanford Health (07/31/25)
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  • Compliance , Privacy, and Contract Manager

    Access Dubuque (Dubuque, IA)
    …timely and accurate execution of compliance requirements. + Lead and oversee all health plan compliance policies and procedures and assist in updating or ... support, create capacity plan , + Serve as a consultant to the health plan for compliance and regulatory questions and concerns. Identify when an issue… more
    Access Dubuque (08/20/25)
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  • Director, Compliance ((Must reside…

    Molina Healthcare (Boston, MA)
    …resolution of investigations. **Knowledge/Skills/Abilities** * Responsible for oversight and management of Health Plan Compliance Directors for all ... compliance with applicable statutes and policies. * Provides leadership to Health Plan Compliance Directors on training and education of compliance more
    Molina Healthcare (07/23/25)
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  • Senior Compliance Analyst

    Centene Corporation (Nashville, TN)
    …issues which may negatively impact service to members. + Assist management with interim health plan compliance officer responsibilities. + Plan , direct ... audits, risk assessments and conducts related to ongoing compliance monitoring activities. + Assist health plans...to ongoing compliance monitoring activities. + Assist health plans in managing relationships with regulatory agencies and… more
    Centene Corporation (08/27/25)
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  • Utilization Management Admissions Liaison RN II

    LA Care Health Plan (Los Angeles, CA)
    …Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications ... (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of California to… more
    LA Care Health Plan (08/02/25)
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  • Corporate Director, Compliance & Privacy

    Parkview Health (Fort Wayne, IN)
    Health Privacy Officer. Assist in developing, maintaining and executing the Parkview Health annual compliance plan . Maintain and update as needed the ... matters requiring legal advice. Serves as a key liaison to the Parkview Health Compliance & Audit Committee. Oversees all compliance subcommittees and work… more
    Parkview Health (08/07/25)
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  • Regional Manager, Compliance - ONSITE

    WMCHealth (Poughkeepsie, NY)
    …adhere to the code of conduct as described in the Westchester Medical Center Health Network Compliance Plan and brochure. Disclaimer: The above statements ... Provider Solutions Inc. City/State: Poughkeepsie, NY Category: Executive/Management Department: Compliance - WMC Health Union: No Position: Full... plan .. + Works closely with the VP, Compliance for the Health Network on … more
    WMCHealth (06/13/25)
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  • Director of Compliance

    WMCHealth (Valhalla, NY)
    …adhere to the code of conduct as described in the Westchester Medical Center Health Network Compliance Plan and brochure. Disclaimer: The above statements ... Provider Solutions Inc. City/State: Valhalla, NY Category: Executive/Management Department: Compliance - WMC Health Union: No Position: Full... plan .. + Works closely with the VP, Compliance for the Health Network on … more
    WMCHealth (08/14/25)
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  • Claims Compliance Auditor I-4

    Centene Corporation (Sacramento, CA)
    …PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective ... and abuse. + Serve as a Claims regulatory resource related to the health plan operations and compliance audits. + Maintain quality and productivity standards… more
    Centene Corporation (08/30/25)
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  • Emory Health Plan , Vice President…

    Emory Healthcare/Emory University (Atlanta, GA)
    PLAN OPERATIONS MANAGEMENT LEAD: + Oversee operational aspects of the health plan , ensuring efficient processes, compliance , and continuous improvement. ... with the third-party administrator (TPA) and ensuring efficient processes, compliance , and continuous improvement. + The Vice President of...to manage the budget and financial performance of the health plan , the VP Pharmacy for performance… more
    Emory Healthcare/Emory University (08/19/25)
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