Top 1609 quality management system Jobs in napa ca

Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $93,690.86 - $117,113.58 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
Health Services Analyst I
Partnership HealthPlan of California —Fairfield, CA
- $77,430.47 - $96,788.08 a year
- Full-time
- Computer literacy
- Mid-level
- Analysis skills
Clinical Service Director, Vision
Petaluma Health Center —Petaluma, CA
- $122,000 - $164,992 a year
- Full-time
- Spanish
- BLS Certification
- English
Quick Apply
Early Childhood Education Coordinator
MEXICAN AMERICAN OPPORTUNITY FOUNDATION —Richmond, CA
- $75,000 - $77,924 a year
- Weekends as needed
- Classroom
- Microsoft Excel
- Microsoft Access
- Paid jury duty
- 403(b) matching
Security Systems Estimator/Sales Executive - Bay Area (commission only / 33% of gm)
Done Right Security, Inc. —Benicia, CA
- $220,000 a year
- Full-time
- Hybrid work
- CRM software
- Background check
- Clean driving record
- Fuel card
- Paid holidays
Quick Apply
4d
Project Manager/Estiimator
Confidential —Santa Rosa, CA
- $90,000 - $110,000 a year
- Full-time
- Background check
- Clean driving record
- Microsoft Excel
- Fuel card
- Paid holidays
Quick Apply
6d
Physician, Gastroenterology, Napa (Full Time)
Northbay Healthcare —Fairfield, CA
- Full-time
- Hybrid work
- Acute care
- Medicine
- BC/BE
- 403(b) matching
- Health insurance
Hospice Social Worker
Savior Hospice Care Inc. —Solano County, CA
- $60,000 - $75,000 a year
- Full-time
- HIPAA
- Mid-level
- Outpatient
Quick Apply
Occupational Therapy Assistant (Full Time, Day)
Northbay Healthcare —Fairfield, CA
- $44.21 - $53.75 an hour
- Weekends as needed
- Hospital
- BLS Certification
- Inpatient
Physical Therapist (PT)
Petaluma Post-Acute Rehab —Petaluma, CA
- $65 - $73 an hour
- Full-time
- CPR Certification
- Skilled nursing facility
- Doctoral degree
Quick Apply
Administrative Assistant
Salud Chiropractic —Rohnert Park, CA
- $25 - $30 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Customer service
- Paid time off
- Employee discount
Quick Apply
Behavioral Health Program Director
Center Point, Inc —San Rafael, CA
- $80,000 - $90,000 a year
- Full-time
- Management
- Addiction Medicine
- Writing skills
- Health insurance
- Dental insurance
Quick Apply
2d
Executive Assistant IV
Confidential —Santa Rosa, CA
- $112,000 - $127,400 a year
- Full-time
- Hospitality
- Office
- In-person
- Health savings account
- Health insurance
Quick Apply
Supervisor, Procurement -IT Systems
Inland Empire Health Plan —California
- $104,041.60 - $137,841.60 a year
- Full-time
- Hybrid work
- Office
- High school diploma or GED
- Supervising experience
- Disability insurance
- Health insurance
Clinical Supervisor (CS) - Santa Rosa
Advanced Crisis Solutions —Santa Rosa, CA
- $90,000 - $110,000 a year
- 8 hour shift
- Background check
- 18 years or older
- CPR Certification
- Wellness program
- Health savings account
Quick Apply
4h
AgeWell PACE Medical Director
AgeWell PACE —Rohnert Park, CA
- $250,000 - $300,000 a year
- Full-time
- Medicine
- Public speaking
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Regional Speech Language Pathologist (SLP)
Spectrum Center Schools and Programs —Solano County, CA
- $110,000 - $125,000 a year
- Full-time
- Background check
- School experience
- Writing skills
- Wellness program
- Mileage reimbursement
Quick Apply
Behavioral Health Clinical Trainee
A Better Way Inc —Fairfield, CA
- Part-time
- Background check
- Clean driving record
- Writing skills
Quick Apply
FIELD ARCHAEOLOGISTS - (Southern California)
SummitWest Environmental —California
- $27 - $32 an hour
- Part-time
- Microsoft Word
- Background check
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
EMT Field Supervisor
West Coast Medical Transport —Napa, CA
- $72,000 - $76,000 a year
- 12 hour shift
- Background check
- 18 years or older
- CPR Certification
- Wellness program
- Continuing education credits
Quick Apply
8d

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Compliance Investigator II

Partnership HealthPlan of California -
Fairfield, CA

Apply Now

Job Details

Full-time
$93,690.86 - $117,113.58 a year

Qualifications

Computer operation
Healthcare fraud investigations
Driver's License
NCQA standards
Desktop applications
Typing
Productivity software
Microsoft Project

Full Job Description

Overview:

The Regulatory Affairs Specialist II has demonstrated competencies in supporting the plan-wide regulatory affairs and compliance program, including activities related to HIPAA and Fraud, Waste, and Abuse (FWA). Under supervision and direction of the Regulatory Affairs Manager, monitors daily Regulatory Affair unit’s operations to ensure the timeliness of deliverables and all case management performance metrics are met, performs internal auditing of all privacy and FWA cases to ensure they meet DHCS requirements and Partnership professional standards. Also provides support to the Regulatory Affairs Specialist (RAS), directs complex regulatory inquiries and responses to regulatory agencies.

Responsibilities:

Proficiently performs all duties of the Regulatory Specialist, independently.
Operates independently, exercising judgement, and providing support and guidance to Regulatory Affairs and Compliance (RAC) staff
Encourages continuous awareness and education of unit staff, which may include development and maintenance of training materials
Creates and monitors daily operational reports to ensure the timely submission of privacy and FWA cases to DHCS
Manages the intake and ongoing maintenance of referral/inquiry platform
Ability to assess, facilitate, and see to completion, referrals and inquiries, of varying complexity and scope, submitted to RAC
Monitors unit trackers to ensure the timeliness of deliverablesare met, making recommendation for improvements in tracking and/or work flows as necessary
Ability to direct unit work, which may include leading unit meetings/discussions and assessment of work outcomes
Competent in assessing and analyzing unit work consistent with established criteria and providing education/training to unit staff as needed
Maintains awareness and understanding of regulatory requirements that govern unit responsibilities
Makes strategic recommendation(s) to improve the accuracy, quality, and/or reporting of case investigations based on audit observations in order to enhance HIPAA and FWA case management performance
Leads or participates in Regulatory Affairs unit projects and has the capacity to represent unit in cross-departmental projects
Assists Regulatory Affairs Manager with developing and maintaining compliance training program including but not limited to:
- Updating new hire compliance trainings and annual training materials
- Conducting targeted department trainings
- Acts as a trainer for the Regulatory Affairs unit
- Backup trainer for new hire trainings or other department trainings
Works with departments on resolving complex regulatory required submissions
Assists Regulatory Affairs Manager with duties related to chairing the PTAS and FWA Subcommittees

Secondary Duties and Responsibilities

Supports regulatory submission process including awareness of deliverables, ad hoc and routine, and completeness and timeliness of submissions
Assists Regulatory Affairs and Compliance unit with the administrative functions to support unit meetings, workgroups, projects and external audits
Other duties as assigned

Qualifications:

Education and Experience

Bachelor’s degree in relevant field preferred or equivalent combination of education and experience; minimum of two (2) years’ experience as a Regulatory Affairs Specialist or relevant experience in managed care with knowledge of the Medi-Cal, and NCQA requirements, and preferably Medicare and Knox Keene. Experience with the investigation and reporting of HIPAA and FWA related incidents.

Special Skills, Licenses and Certifications

Highly proficient in applicable business software applications including PC usage, Microsoft Word, PowerPoint, Excel, Project, typing speed of 30 wpm. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business

Performance Based Competencies

Excellent oral and written communication skills. Excellent organizational skills with ability to prioritize assignments, maintain effective filing systems, and meet deadlines. Ability to work under minimal supervision and exercise independent judgment. Diplomacy and tact in handling sensitive information regarding personnel affairs as required. Ability to interact with executives and vendors effectively, handling all assignments with efficiency. Must be able to handle multiple tasks and meet deadlines. Excellent judgment.

Work Environment And Physical Demands

Ability to use a computer keyboard and other business machines. More than 50% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying sizes, weighing up to 35 pounds.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

quality management system jobs in napa ca

Compliance Investigator II

Health Services Analyst I

Clinical Service Director, Vision

Early Childhood Education Coordinator

Security Systems Estimator/Sales Executive - Bay Area (commission only / 33% of gm)

Project Manager/Estiimator

Physician, Gastroenterology, Napa (Full Time)

Hospice Social Worker

Occupational Therapy Assistant (Full Time, Day)

Physical Therapist (PT)

Administrative Assistant

Behavioral Health Program Director

Executive Assistant IV

Supervisor, Procurement -IT Systems

Clinical Supervisor (CS) - Santa Rosa

AgeWell PACE Medical Director

Regional Speech Language Pathologist (SLP)

Behavioral Health Clinical Trainee

FIELD ARCHAEOLOGISTS - (Southern California)

EMT Field Supervisor

I want to receive the latest job alert for quality management system in napa ca

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