Top 249 Healthcare compliance Jobs in California

Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $96,970.04 - $121,212.56 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
Contract Substance Abuse Technician / Case Manager – Part-Time
Witty Personnel —Redding, CA
- $23 - $25 an hour
- Part-time
- Addiction Medicine
- HIPAA
- Mid-level
Quick Apply
4d
Clinical Director/Quality and Compliance For Residential Drug and Alcohol Program
CRASH, Inc. —San Diego, CA
- $85,000 - $95,000 a year
- Full-time
- LMFT
- Management
- Licensed Clinical Social Worker
- 403(b) matching
- Health insurance
Quick Apply
HR Compliance Coordinator
WellSpace Health —Sacramento, CA
- $30.14 - $39.18 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Paid jury duty
- Paid holidays
Quick Apply
Pharmacy Part D Auditor
Clever Care Health Plan —Huntington Beach, CA
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Mid-level
Risk Adjustment Coding Auditor
Clever Care Health Plan —Huntington Beach, CA
- $72,800 - $80,000 a year
- Full-time
- Hybrid work
- Background check
- Nursing
- Microsoft Excel
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
Quick Apply
Contract Substance Abuse Technician / Case Manager – Part-Time
Witty Personnel —Los Angeles, CA
- From $28 an hour
- Part-time
- Addiction Medicine
- HIPAA
- Mid-level
Quick Apply
1d
Dental Compliance Manager
Confidential —El Segundo, CA
- $70,304 - $90,000 a year
- Full-time
- Dental office
- OSHA
- 5 years
- Health insurance
- Dental insurance
Quick Apply
1d
Manager, Accreditation & Regulatory Compliance (White Memorial)
Adventist Health —Long Beach, CA
- Full-time
- Hospital
- Office
- 3 years
2d
Manager, Accreditation & Regulatory Compliance (White Memorial)
Adventist Health —Bell Gardens, CA
- Full-time
- Hospital
- Office
- 3 years
2d
Manager, Accreditation & Regulatory Compliance (White Memorial)
Adventist Health —North Hollywood, CA
- Full-time
- Hospital
- Office
- 3 years
2d
Manager, Accreditation & Regulatory Compliance (White Memorial)
Adventist Health —Culver City, CA
- Full-time
- Hospital
- Office
- 3 years
2d
General Counsel – Experienced Generalist Attorney
Healthcare Support LLC —Encino, CA
- $300,000 - $400,000 a year
- Full-time
- Hybrid work
- 11+ years
- Senior level
- Health insurance
- Dental insurance
Quick Apply
2d
Compliance Manager (Remote)
Rula —Los Angeles, CA
- $152,000 - $176,700 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Master's degree
- Paid parental leave
- Health savings account
Healthcare Regulatory & Compliance Consultant
Lifekind Health —Palm Desert, CA
- $90,000 - $100,000 a year
- Mid-level
- In-person
Quick Apply
Healthcare Compliance Office (HCO) Program Ops Manager - Program Operations
Genentech —San Francisco, CA
- $111,790 - $207,610 a year
- Online Application
- Customer service
- Office
- 3 years
Compliance Analyst
UCLA Health —Los Angeles, CA
- $88,900 - $190,300 a year
- Research
- Mid-level
- 3 years
Privacy Analyst - Office of Healthcare Compliance - Full Time 8 Hour Days (Exempt) (Non-Union)
Keck Medical Center of USC —Los Angeles, CA
- $84,365 - $138,330 a year
- 8 hour shift
- Acute care
- Background check
- Research
Compliance Officer
AIDS Healthcare Foundation —Los Angeles, CA
- $155,000 - $165,000 a year
- HIPAA
- Senior level
- Health insurance
Quick Apply

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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.

Apply Now

Refine Your Search

healthcare compliance jobs in california

Compliance Investigator II

Contract Substance Abuse Technician / Case Manager – Part-Time

Clinical Director/Quality and Compliance For Residential Drug and Alcohol Program

HR Compliance Coordinator

Pharmacy Part D Auditor

Risk Adjustment Coding Auditor

Call Center Quality Assurance Auditor

Contract Substance Abuse Technician / Case Manager – Part-Time

Dental Compliance Manager

Manager, Accreditation & Regulatory Compliance (White Memorial)

Manager, Accreditation & Regulatory Compliance (White Memorial)

Manager, Accreditation & Regulatory Compliance (White Memorial)

Manager, Accreditation & Regulatory Compliance (White Memorial)

General Counsel – Experienced Generalist Attorney

Compliance Manager (Remote)

Healthcare Regulatory & Compliance Consultant

Healthcare Compliance Office (HCO) Program Ops Manager - Program Operations

Compliance Analyst

Privacy Analyst - Office of Healthcare Compliance - Full Time 8 Hour Days (Exempt) (Non-Union)

Compliance Officer

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