Compliance Audit Services Specialist, Principal

Your Role The Promise Compliance Audit Services team oversees all functions of an effective Compliance Program for Blue Shield of California Promise Health Plan. The Compliance Audit Services, Principal will report to the Senior Director, Compliance Audit Services. In this role you will be involved in monitoring and oversight of operational business areas to...

Your Role The Promise Compliance Audit Services team oversees all functions of an effective Compliance Program for Blue Shield of California Promise Health Plan. The Compliance Audit Services, Principal will report to the Senior Director, Compliance Audit Services. In this role you will be involved in monitoring and oversight of operational business areas to...

Job Overviewdestinationone Consulting is a leading recruitment agency specializing in various sectors, including CleanTech, Education and EdTech, Government, Health and MedTech, Healthcare and Wellness, Legal, Not-For-Profit, and Public Accounting. We strive to build a robust talent database, enabling our recruiters to efficiently match job seekers with...

Compliance Specialist - Affordable HousingAbout Us:Avanath is a leading provider of affordable housing solutions, dedicated to making a positive impact on the lives of hardworking American families.Job Summary:We are seeking a highly skilled and detail-oriented Compliance Specialist to join our team. As a Compliance Specialist, you will be responsible for...

Job Title: Clinical Audit Specialist**Salary:** $70,000 - $90,000 per yearWe are seeking a skilled Clinical Audit Specialist to join our team at Molina Healthcare. In this role, you will be responsible for supporting the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse.Key Responsibilities:Perform accurate and...

Job Title: Human Resources Generalist - Onboarding and Compliance Specialist About The Children's ClinicThe Children's Clinic, a mission-driven healthcare organization, is seeking a detail-oriented and highly organized Human Resources Generalist to support daily HR operations and ensure compliance across our healthcare facilities. As a member of our HR...

**Job Title:** Healthcare Compliance SpecialistBlue Shield of California is seeking a highly skilled and detail-oriented Healthcare Compliance Specialist to join our team. In this role, you will be responsible for reviewing medical documents and applying clinical criteria to establish the most appropriate level of care.**Responsibilities:Conduct...

Dao Emerging Technologies is seeking a talented Audit and Compliance Manager to oversee its SOC compliance program. As a key member of our audit and compliance team, you will be responsible for leading the testing and review of internal controls, monitoring control deficiencies, and supporting management in resolving process issues.The ideal candidate will...

Vensure Employer Services is seeking an experienced Audit and Accounting Specialist to join our team. In this role, you will be responsible for conducting audits and reviews of financial transactions, identifying discrepancies, and implementing corrective actions.The estimated salary for this position is $50,000 - $70,000 per year, depending on...

At Blue Shield of California, we're seeking a highly skilled Healthcare Compliance Specialist to join our Facility Compliance Review team. As a key member of this team, you will play a vital role in reviewing post-service prepayment facility claims for contract compliance, industry billing standards, medical necessity, and hospital-acquired conditions/never...

Role OverviewWe are looking for a highly skilled Auditing and Reporting Specialist to join our team at Hilton Grand Vacations. In this role, you will be responsible for performing complex audits, analyzing data, and providing accurate financial reports to management.You will work closely with the Accounting team to ensure the financial integrity of our...

Job SummaryThe Provider Contract Recruiter (Network/Sales) role is a critical member of the network development team at Dental Health Services. This position assumes overall responsibility for successfully managing relationships with dental organizations as accounts, ensuring access to care requirements are met and supporting the growth of strong, stable...

Job Title: Medical Claims Audit ExpertAbout the RoleAt Advanced Medical Manage, we are seeking a highly skilled Medical Claims Audit Expert to join our team. As a key member of our audit team, you will play a critical role in ensuring compliance with regulatory requirements and optimizing our claims processing operations.ResponsibilitiesPrepare and...

About the JobThis is an exciting opportunity to join Blue Shield of California as a Principal Healthcare Transformation Specialist. You will play a critical role in developing and implementing clinical programs that improve patient outcomes and drive operational excellence.Key ResponsibilitiesLead the development and implementation of clinical program...

Key Responsibilities Review medical documents and apply clinical criteria to establish the most appropriate level of care. Conduct retrospective utilization reviews and first-level determination approvals for members using BSC evidenced-based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of...

Company Overviewdestinationone Consulting is a leading recruitment agency specializing in diverse sectors, including Healthcare, Health Tech, Government, Municipalities, Non-Profits, Legal, Public Accounting, and Food. We are building a comprehensive database of job opportunities to match candidates with suitable roles as they arise.Job SummaryAudit...

Job DescriptionAbout Us:Beach Front Property Management Inc. is a leading provider of property management services, specializing in enhancing the value and performance of both residential and commercial properties. We are known for our professionalism, integrity, and commitment to excellence. Currently, we are looking for a detail-oriented and motivated...

Senior Healthcare Compliance Specialist Job DescriptionIn this challenging role, you will be responsible for conducting retrospective utilization reviews to ensure compliance with medical necessity and billing standards.The ideal candidate will possess strong analytical skills and effective communication to manage claims and improve quality of care. You will...

At NextEra Energy, Inc., we are committed to creating a cleaner environment for future generations.We invite you to join our world-class team as a Renewable Energy Compliance Specialist.The Power Generation Division (PGD) Senior Compliance Technical Specialist will support the NERC Operations and Planning (O&P) Compliance team by applying engineering...

About the Roledestinationone Consulting, a recruitment expert across various sectors, is committed to connecting job seekers with relevant opportunities.We specialize in CleanTech, Education and EdTech, Government, Health and MedTech, Healthcare and Wellness, Legal, Not-For-Profit, and Public Accounting. Our dedication to Integrity, Transparency, and...