- Molina Healthcare (Owensboro, KY)
- **Job Description** **Job Summary** The Sr Auditor , Delegation Oversight will independently perform audits of multi-delegated functions with minimal oversight ... and State Medicaid entities. **Job Duties** + Oversees Utilization Management, Claims , Organizational Credentialing, and Crisis Call Center delegated activities. +… more
- Fallon Health (Worcester, MA)
- …Committee and plays a key role in auditing risks identified in the organization. The Senior Internal Auditor plays a key role in implementing the annual audit ... plan. The Senior Internal Auditor conducts audits and related...insurance industry. + At least one-year experience in a Sr . Auditor capacity. + Information Technology auditing… more
- HCA Healthcare (Campbell, CA)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Claim Auditor today with HCA Healthcare . **Benefits** HCA Healthcare , offers a ... provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr . HCA Healthcare Co-Founder If you are looking for an opportunity… more
- Nuvance Health (Danbury, CT)
- Senior Compliance Coding Auditor - Inpatient Location: Danbury, CT, United States Requisition ID: 50395 Salary Range: 27.91 - 51.83 HOURLY Work Shift: Monday - ... the Special Associate Compliance Officer (SACO) Physician Audit & Billing, the Senior Inpatient Professional Auditor provides Hospital Inpatient and Outpatient… more
- Immigration and Customs Enforcement (IN)
- …for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional Utilization ... position Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program activities… more
- Option Care Health (Chicago, IL)
- …advanced analytics techniques to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance ... Up to 25% **Preferred Qualifications & Interests (PQIs)** + Certified in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare ? Bring your true colors to blue. Reporting to the Senior Vice President of Risk and Audit Management, the Vice President of ... Enterprise Risk Management strategy and objectives. + Work closely with senior executives to understand and manage enterprise strategic, financial, and operational,… more
- Providence (OR)
- …Accredited Healthcare Fraud Investigator (AHFI), Certification as an Internal Auditor (CIA), Healthcare Compliance certification (CHC), or equivalent + ... a workload with multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing and performing compliance… more
- Somatus (Mclean, VA)
- …grow, and be the best version of themselves, including: + Subsidized, personal healthcare coverage (medical, dental vision) + Flexible Paid Time Off (PTO) + ... relevant actuarial estimates. Leads the development/compilation of the risk premium, claims and shared savings forecasting models used in the corporate… more