- 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
- 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
- Medical Mutual of Ohio (OH)
- …strategies and goals in alignment with regulatory specifications for the annual Healthcare Effectiveness Data and Information Set (HEDIS) lifecycle processes for all ... Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS).… 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
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