Top 1139 Representative Jobs in Vacaville, Ca

Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $96,970.04 - $121,212.56 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
Product Support Sales Representative (PSSR)
BEJAC CORPORATION —Fairfield, CA
- $48,000 - $100,000 a year
- Full-time
- Background check
- Microsoft Outlook
- Sales
- Paid holidays
- Health insurance
Quick Apply
Behavioral Health Specialist I
Turning Point Community Programs —Fairfield, CA
- $24 - $26 an hour
- On call
- Skilled nursing facility
- Driver's License
- Bachelor's degree
Quick Apply
Area Manager - Fairfield, CA
Right at School —Fairfield, CA
- $70,000 - $75,000 a year
- Full-time
- Hybrid work
- Current TB test
- Customer service
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Property Manager - Vacaville, CA
Sentinel Real Estate Corporation —Vacaville, CA
- $85,000 a year
- Full-time
- Bachelor of Science
- Mid-level
- Office
- Health savings account
- Health insurance
Quick Apply
Customer Service Representative 1
Recology —Vacaville, CA
- $29.18 an hour
- Monday to Friday
- Computer literacy
- Writing skills
- Office
- Wellness program
- Paid holidays
Customer Service Representative, CC
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Spanish
- Mid-level
- Administrative experience
Claims Customer Service Representative I
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
Patient Services Representative II, Women's Health
Sutter Health —Fairfield, CA
- $26.06 - $36.48 an hour
- 8 hour shift
- Microsoft Outlook
- High school diploma or GED
- Organizational skills
3d
Customer Service Representative 1 - Bilingual
Recology —Vacaville, CA
- $30.18 an hour
- Monday to Friday
- Spanish
- Computer literacy
- Writing skills
- Wellness program
- Paid holidays
Safety Representative
AC Transit —California
- $105,932 - $126,493 a year
- Online Application
- Mid-level
- Office
- Bachelor's degree
- Wellness program
- Commuter assistance
Customer Service Representative
Pearce Heating & Air Conditioning, Inc. —Winters, CA
- $18 - $20 an hour
- Weekends as needed
- Customer service
- English
- HVAC
- Paid training
- Paid holidays
Quick Apply
Executive Assistant
Partnership HealthPlan of California —Fairfield, CA
- $88,154.59 - $110,193.23 a year
- Full-time
- Research
- Mid-level
- Office
Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Contact Center Representative - RETURNSHIP ELIGIBLE
Travis Credit Union —Vacaville, CA
- $19.98 - $29.01 an hour
- Hybrid work
- Spanish
- Microsoft Outlook
- English
- Health insurance
- Dental insurance
Program Support Assistant
US Veterans Health Administration —Fairfield, CA
- $63,081 - $82,007 a year
- Weekends as needed
- Background check
- Microsoft Outlook
- Psychiatry
8d
Team Member
Jamba —Vacaville, CA
- Overtime
- Serving
- No education required
- 16+ years old
Quick Apply
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Full-time
- Research
- Mid-level
- Office
Admissions Representative
Milan Institute —Vacaville, CA
- $19.00 - $21.50 an hour
- Full-time
- Mid-level
- High school diploma or GED
- University
- Paid holidays
- Health insurance
Quick Apply
Program Manager I
Partnership HealthPlan of California —Fairfield, CA
- $88,154.59 - $110,193.23 a year
- Microsoft Excel
- Microsoft Outlook
- Customer service
3d

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Compliance Investigator II

Partnership HealthPlan of California -
Fairfield, CA

Apply Now

Job Details

Full-time
$96,970.04 - $121,212.56 a year

Qualifications

Computer operation
Healthcare fraud investigations
Driver's License
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.

HIRING RANGE:

$96,970.04 - $121,212.56

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.

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Refine Your Search

representative jobs in vacaville, ca

Compliance Investigator II

Product Support Sales Representative (PSSR)

Behavioral Health Specialist I

Area Manager - Fairfield, CA

Property Manager - Vacaville, CA

Customer Service Representative 1

Customer Service Representative, CC

Claims Customer Service Representative I

Patient Services Representative II, Women's Health

Customer Service Representative 1 - Bilingual

Safety Representative

Customer Service Representative

Executive Assistant

Claims Resolution Coordinator

Contact Center Representative - RETURNSHIP ELIGIBLE

Program Support Assistant

Team Member

Claims Examiner II

Admissions Representative

Program Manager I

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