- Ventura County (Ventura, CA)
- … medical directors, providers, and members to resolve service issues, ensure regulatory compliance (DMHC, NCQA, HEDIS), and support wellness, prevention, and ... Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that members… more
- Houston Methodist (The Woodlands, TX)
- …compliance with ethical and legal business practices and accreditation/ regulatory /government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Directs, develops and ... performs associated actions upon non- compliance (ie, licensure/certification compliance , focal point review requirements, disaster plan,... staff to meet long term objectives. + Assures compliance with the regulatory agencies in the… more
- Amazon (Arlington, VA)
- …import/export regulatory or procedural changes that impact the trade compliance governance program. Clearly communicate the changes and associated impact on the ... Services (AWS) is looking for an experienced Global Trade Compliance Program Manager to build upon our controls and...this role will build a best in class internal review program. You will interact with AWS Development, Datacenter… more
- Robert Half Legal (Villa Rica, GA)
- …sectors. The ideal candidate will have a strong background in contracts, compliance , and industry regulations. * Review and complete pre-qualification forms ... orders when necessary. * Maintain accurate records of insurance policies and regulatory licenses. Requirements * Proven experience in compliance and contract… more
- PennyMac (Carrollton, TX)
- …Act Red Flags Rule, Elder Financial Abuse and OFAC Sanctions + Investigate, review , and maintain advanced awareness of regulatory changes and industry trends ... through the complete mortgage journey. A Typical Day The Compliance Fraud Investigation Analyst will work with Corporate ...have you covered. Some key benefits include: + Comprehensive Medical , Dental, and Vision + Paid Time Off Programs… more
- City National Bank (Los Angeles, CA)
- *SENIOR CREDIT RISK REVIEW OFFICER* WHAT IS THE OPPORTUNITY? The Credit Risk Review Department (CRR), is part of the 3rd line of defense, and as such is ... recommend and effect process changes regarding credit risk management activities, regulatory issues related to credit risk, credit policy, and general credit… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …development specialist to develop standard work and expectations for the utilization review process, including timely medical necessity screening to ensure ... accurate perioperative pre-authorization and patient class order reconciliation process. Assesses compliance to regulatory and health plan requirements for… more
- US Tech Solutions (IL)
- …State + Ensure all **promotional materials** are reviewed by cross functional teams, medical , regulatory , compliance and others as required by Client ... Materials Review Process, as needed; communicate with teams to ensure local review compliance + Manage Affiliate processes as required for local events… more
- Delta Air Lines, Inc. (Atlanta, GA)
- …and operational excellence. **Key Responsibilities** + Support curriculum development, regulatory compliance , and training initiatives. + Collaborate with ... operations or training. The coordinator contributes to curriculum development, compliance efforts, and training enhancements, ensuring alignment with regulatory… more
- Tenet Healthcare (Detroit, MI)
- …in the case management system Follows the payor dispute processes utilizing secondary medical review , peer to peer and payor type changes (25% daily, ... is sequenced and at the appropriate level of care Compliance with state and federal regulatory requirements,...Medical Necessity and submits case for Secondary Physician review per Tenet policy Ensures timely communication and documentation… more