Top 1437 Certified professional Jobs in Redlands, Ca

Compliance Auditor II
Inland Empire Health Plan —Rancho Cucamonga, CA
- $80,059.20 - $106,059.20 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Disability insurance
- Health insurance
Per Diem Nurse
Building Bridges Foster Family Agency —San Bernardino, CA
- $105 - $120 a day
- Part-time
- Spanish
- Nursing
- LVN
Quick Apply
Group Facilitator-Substance Abuse Treatment
Zinnia Health —Lake Arrowhead, CA
- From $28 an hour
- Full-time
- Background check
- CPR Certification
- Addiction Medicine
- Health insurance
- Dental insurance
Quick Apply
Inspection Assistant, BAR (San Bernardino Valley College)
Foundation for California Community Colleges —San Bernardino, CA
- $18 - $22 an hour
- Email
- Experience equivalent to degree accepted
- In-person
- 1 year
- Health savings account
- Health insurance
Freelance CSST Certified Environmental Technician
SOS Restoration Inc. —California
- $25 - $50 an hour
- Part-time
- Mid-level
- Residential
- Driver's License
Quick Apply
3d
Wellbeing Specialist
Redlands Community Hospital - HUMAN RESOURCES —Redlands, CA
- $92,012.80 - $139,214.40 a year
- Full-time
- LMFT
- Management
- BLS Certification
13d
Community Support Specialist/DSP
Community Integration Network, Inc. —Highland, CA
- $16.90 - $19.00 an hour
- Part-time
- Background check
- Experience working with individuals with developmental disabilities
- CPR Certification
- Health insurance
- Dental insurance
Quick Apply
Behavior Support Specialist
Dynamic Hope Schools —Riverside, CA
- $35 - $40 an hour
- Full-time
- HIPAA
- Mid-level
- Psychology
- Paid time off
- Flexible schedule
Quick Apply
House Manager & Family Assistant (with meal prep support & light childcare)
Sage Haus —Redlands, CA
- $37 - $42 an hour
- Part-time
- Background check
- CPR Certification
- Driver's License
- Mileage reimbursement
Quick Apply
Patient Care Assistant-Alternate Care Unit
Loma Linda University Health —Loma Linda, CA
- $25.00 - $26.91 an hour
- Full-time
- Spanish
- Microsoft Outlook
- Computer literacy
Outreach and Enrollment Counselor (Riverside)
Neighborhood Healthcare —Riverside, CA
- $27.21 - $38.10 an hour
- Weekends as needed
- Spanish
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
7d
Admissions Advisor
West Coast University, Inc. —Ontario, CA
- $28.53 - $38.51 an hour
- Full-time
- Mid-level
- Microsoft Office
- High school diploma or GED
PACE Care Assistant
Loma Linda University Health —Redlands, CA
- $25.00 - $26.91 an hour
- Full-time
- Spanish
- Vital signs
- Microsoft Outlook
Certified Occupational Therapist Assistant
Sun Mar Health Care —Fontana, CA
- Part-time
- Mid-level
Quick Apply
Medical Assistant
Surgical Edge —San Bernardino, CA
- $18 - $21 an hour
- Full-time
- Spanish
- Vital signs
- Surgery
Quick Apply
10d
Admissions Advisor - Hybrid
American Career College —Ontario, CA
- $25.95 - $35.04 an hour
- Full-time
- Microsoft Office
- High school diploma or GED
- University
Office Support Coordinator (Administrative Support Coordinator I) , Palm Desert Indian Wells Student Services
California State University —San Bernardino, CA
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Health insurance
11d
School-Based Student Wellness Coach - Rancho Cucamonga, CA
Wellness Together —Rancho Cucamonga, CA
- $24 - $25 an hour
- School experience
- Psychology
- Social Work
- Wellness program
- Health insurance
Brand Specialist
Beauty Barrage —Redlands, CA
- $24 - $26 an hour
- Part-time
- Merchandising
- Mid-level
- Driving
- Health insurance
- Paid time off
Food Runner/ Expo - La Popular Redlands
Eureka Restaurant Group —Redlands, CA
- 18 years or older
- Restaurant
- Food Handler Certification
- Employee assistance program
- Employee discount
Quick Apply

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certified professional jobs near redlands, ca

Compliance Auditor II

Inland Empire Health Plan -
Rancho Cucamonga, CA

Apply Now

Job Details

Full-time
$80,059.20 - $106,059.20 a year

Benefits

457(b)
Disability insurance
Health insurance
On-site gym
Dental insurance
Flexible spending account
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Managed care
Managed care organization experience
Health insurance knowledge
Quality improvement
Healthcare quality audits

Full Job Description

Overview:

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

The Compliance Auditor II conducts comprehensive audits and reviews across the Plan, including assigned areas and Plan delegates, to ensure adherence to Federal, State, and contractual regulatory requirements. Identifies and assesses risks impacting overall compliance, drafts detailed audit findings and actionable recommendations, and evaluates operations, policies, and processes throughout the Plan. Conducts evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues. Issues corrective action plans and reviews for acceptance to ensure that all compliance issues are appropriately addressed. Performs validation audits to determine if actions have been taken to mitigate identified risks and conducts routine monitoring across the Plan to address compliance concerns and emerging risks. Participates in special reviews as necessary.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

Competitive salary
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Life, short-term, and long-term disability options
Career advancement opportunities and professional development
Wellness programs that promote a healthy work-life balance
Flexible Spending Account – Health Care/Childcare
CalPERS retirement
457(b) option with a contribution match
Paid life insurance for employees
Pet care insurance

Key Responsibilities:

Conduct audits and testing procedures of assigned areas and Plan delegates, including detailed testing activities, documenting findings in audit work papers, developing detailed document requests lists, conducting walk-throughs, and proposing recommendations for improvement.
Develop and maintain audit tools based on regulatory compliance with DHCS, DMHC, and CMS requirements.
Document audit conclusions that are based on a complete understanding of the process, circumstances, and risk.
Perform validation audits to determine if actions have been taken to mitigate risks identified.
Support the development and acceptance of corrective action plans (CAPs) from internal departments and delegates to ensure accuracy and regulatory adherence.
Validate corrective action plans (CAPs) from internal departments and delegates to ensure appropriate completion and make necessary recommendations as needed for compliance.
Perform evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues.
Support the identification of and communicates issues raised, offering recommended solutions relevant to business and risk.
Conduct regulatory research and provides interpretation of regulations to ensure appropriate application.
Support the maintenance of risks for assigned areas in the Compliance Risk Universe to ensure risk mitigations plans are developed and risks assessed and refreshed as needed.
Support the development of risk assessments to identify compliance risks posed to the Plan.
Conduct routine monitoring activities to ensure compliance with regulatory and contractual requirements.
Assist with reports for presentation to the Executive Compliance Committee and the IEHP Governing Board.
Conduct compliance assessments as needed.
Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications:

Education & Requirements

Minimum or five (5) or more years in managed care operations requierd, working with one or more of the following areas: Utilization Management, Claims, Pharmacy Operations, Compliance, Delegation Oversight, Quality Management, Care Management, and/or Grievances and Appeals
Demonstrated experience, at a professional level, in an audit role
Experience with interpretation and/or implementation of California managed care regulations
Two (2) years of audit or quality assurance/quality improvement experience required
Bachelor’s degree from an accredited institution required
- In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position
- This experience is in addition to the minimum years listed in the Experience Requirements above
Certified Internal Auditor (CIA), Certified Health Care Compliance (CHC), Certified Healthcare Auditor (CHA), and/or CHIAP (Certified Healthcare Internal Audit Professional) preferred

Key Qualifications

Demonstrated understanding of audit standards and requirements, statistical data interpretation and applicability, risk assessment and control environments, audit theory and processes, and of the professional practice standards of internal auditing
Demonstrated current knowledge of business ethics and compliance risks and the knowledge to assist with management of those risks in a dynamic health care environment
Proficient knowledge of CMS Program Audit Protocols, DHCS Technical Assistance Guides, and DMHC Technical Assistance Guides
Knowledge of regulatory research and regulations that apply to California Managed Care Health Plans
Possess strong written and verbal communication skills, including a strong business writing aptitude
Possess strong problem solving and creative thinking skills and the ability to reprioritize workload as needed
Must be detail oriented, self-directed, and work with minimal supervision, both independently and in teams
Requires well-developed skills in problem identification, analysis, resolution, organization, prioritization, timeliness, and attention to detail
Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook, etc.). Advanced skills in MS Excel preferred
Effective in a consulting role with the ability to become a trusted advisor
Ability to maintain excellent interpersonal relationships within the department and at all levels of the organization
Ability to organize thoughts and data into well-organized communications and reports

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location:

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)

Pay Range: USD $80,059.20 - USD $106,059.20 /Yr.

Apply Now

Refine Your Search

certified professional jobs in redlands, ca

Compliance Auditor II

Per Diem Nurse

Group Facilitator-Substance Abuse Treatment

Inspection Assistant, BAR (San Bernardino Valley College)

Freelance CSST Certified Environmental Technician

Wellbeing Specialist

Community Support Specialist/DSP

Behavior Support Specialist

House Manager & Family Assistant (with meal prep support & light childcare)

Patient Care Assistant-Alternate Care Unit

Outreach and Enrollment Counselor (Riverside)

Admissions Advisor

PACE Care Assistant

Certified Occupational Therapist Assistant

Medical Assistant

Admissions Advisor - Hybrid

Office Support Coordinator (Administrative Support Coordinator I) , Palm Desert Indian Wells Student Services

School-Based Student Wellness Coach - Rancho Cucamonga, CA

Brand Specialist

Food Runner/ Expo - La Popular Redlands

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