• Quality Audit Analyst

    Robert Half Accountemps (Minneapolis, MN)
    …experience in quality assurance, auditing, or a related field, preferably within the healthcare industry. * Rx claims experience * Strong analytical skills with ... Description We are looking for a skilled Quality Audit Analyst to join our team in Minneapolis,...within the Enrollment Employer Installation division of a leading healthcare organization. Your expertise in quality assurance and process… more
    Robert Half Accountemps (05/19/25)
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  • Manager, Healthcare Auditing & Monitoring

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    …Chief Compliance Officer in executing an effective compliance program. The Manager, Healthcare Law Auditing & Monitoring, executes the annual plan by conducting ... notes, speaker programs, and HCP spend to help to ensure compliance with healthcare laws, regulations and guidance (such as the Anti-Kickback Statute, False … more
    Otsuka America Pharmaceutical Inc. (04/12/25)
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  • Compliance & Privacy Partner

    Emory Healthcare/Emory University (Atlanta, GA)
    …Career at Emory University** **Be inspired. Be valued. Belong.** At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ... The Compliance & Privacy Partner reports to the Chief Compliance Officer of Emory Healthcare (CCO EHC) and is responsible for supporting the daily operations of the… more
    Emory Healthcare/Emory University (06/04/25)
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  • Division Director of Research GME

    HCA Healthcare (Austin, TX)
    …+ Ensuring compliance with federal, state and HCA regulations, policies, procedures, and audit requirements in the use of patient data for research purposes + ... new analytical capabilities. + Constructing and manipulating large electronic claims datasets, knowledge in domain modeling, relational database design, programming… more
    HCA Healthcare (05/16/25)
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  • Benefit Administration Analyst - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
    Sharp HealthCare (05/11/25)
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  • Manager Benefit Administration - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
    Sharp HealthCare (05/11/25)
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  • Compliance Analyst II

    Maxim Healthcare Services (Columbia, MD)
    Maxim Healthcare Corporate Services is currently seeking a Compliance Analyst II. The Compliance Analyst II must maintain a comprehensive understanding of ethical ... late timecards, patient loggings, reconciliations, etc. + Summarizes ad hoc audit findings and preliminary recommendations for management review + Prepares reports… more
    Maxim Healthcare Services (05/14/25)
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  • Senior Healthcare Decision Support Analyst…

    Trinity Health (Columbus, OH)
    …We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety ... of professional roles including information technology, financial analysis, audit , provider relations and more. **About the job:** Senior Decision Support Analyst… more
    Trinity Health (05/14/25)
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  • Clinical Denials Coding Review Specialist

    HCA Healthcare (Nashville, TN)
    **Description** **Introduction** Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career ... on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
    HCA Healthcare (05/29/25)
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  • Care Coordinator - SCMG Utilization Management…

    Sharp HealthCare (San Diego, CA)
    …of the requested service. This position is responsible for conducting retrospective claims review for services to determine the medical appropriateness of the ... completion of Medical Assistant Program or equivalent. + 2 Years experience in healthcare with experience in medical codes, medical terminology, and data entry .… more
    Sharp HealthCare (06/05/25)
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