• Compliance Officer

    University of Utah (Salt Lake City, UT)
    Details **Open Date** 09/12/2025 **Requisition Number** PRN43093B **Job Title** Compliance Officer **Working Title** Compliance Officer **Career Progression ... U of U Health - Academics **Department** 01663 - COMPLIANCE SERVICES **Location** Campus **City** Salt Lake City, UT...medical auditing, Federal healthcare program policies and requirements (including Medicare Parts A and B), and ICD -10, CPT… more
    University of Utah (09/13/25)
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  • Quality Compliance Professional

    Humana (Richmond, VA)
    …put health first** Humana Healthy Horizons in Virginia is seeking Quality Compliance Professionals who will be responsible for conducting audits and assessments to ... supports continuous improvement efforts by identifying areas of risk or non- compliance and recommending corrective actions. The Quality Compliance Professional… more
    Humana (09/11/25)
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  • VP Coverage Compliance

    Baylor Scott & White Health (Dallas, TX)
    …may vary based on position type and/or level **Job Summary** VP Coverage Compliance is responsible for planning, developing, and enforcing compliance programs ... (QA), collectively known as the "Coverage" system. This includes Health Plan and QA compliance and in partnership with the system to provide compliance hotline… more
    Baylor Scott & White Health (09/07/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Des Moines, IA)
    …fuels our passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The ... Compliance Principal is responsible for supporting Oversight and Monitoring...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
    Prime Therapeutics (07/25/25)
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  • Clinical Coding Supervisor

    ZoomCare (Tigard, OR)
    …CPT, HCPCS, and ICD-10 code assignment for professional medical services + Monitor compliance with Center of Medicare and Medicaid, AMA, and commercial payer ... expertise in professional coding practices. + Strong understanding of Medicare billing guidelines, documentation standards, and compliance regulations,… more
    ZoomCare (08/29/25)
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  • Compliance Registered Nurse

    Humana (Indianapolis, IN)
    …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and… more
    Humana (09/20/25)
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  • Clinical Investigator

    MVP Health Care (Rochester, NY)
    …and State Anti-Fraud investigation and reporting requirements including HIPAA, CMS, Medicare , Medicaid, and any corporate compliance initiatives or policies. ... you have a passion for problem solving and investigations, commitment to compliance and ethical standards and dedication to continuous learning and improvement.… more
    MVP Health Care (09/20/25)
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  • Director of Clinical Services - Home Health

    Jet Health (Englewood, CO)
    …program to ensure accuracy and regulatory fulfillment of timely documentation. + Compliance :Focus on Medicare Quality Measures and other industry standards to ... ensure compliance . + Staffing:Ensure that staffing ratios are sound, and...skills. + Comprehensive knowledge of home health regulations and compliance standards. + Excellent communication and interpersonal skills. +… more
    Jet Health (09/19/25)
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  • Director, Government Pricing

    Sanofi Group (Morristown, NJ)
    …pricing team responsible for executing all government pricing calculations in full compliance with all Medicaid, Medicare and VA Healthcare Act regulations. ... calculation, analysis, and reporting of all government pricing programs in compliance with applicable laws and regulations. Maintaining timely and accurate… more
    Sanofi Group (08/29/25)
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  • Accountant C (Office of Clinical Research)

    University of Pennsylvania (Philadelphia, PA)
    …rates. + Work with the Unit Manager to conduct monitoring of research finance compliance with the Medicare Clinical Trial Policy, including review of key ... and supplemental industry-sponsored clinical research proposals in Penn-ERA to ensure compliance with PSOM overhead policy. + Process Research Billing Numbers,… more
    University of Pennsylvania (09/17/25)
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