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
Compliance / QA / Revenue Integrity Manager
Prodigy Healthcare Inc. —Fresno, CA
- $80,000 - $120,000 a year
- Full-time
- Management
- Current TB test
- 5 years
- Health insurance
- Dental insurance
Quick Apply
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
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
12d
Laboratory Quality & Compliance Safety Specialist - West Valley Hospital
UCLA Health —West Hills, CA
- $119,700 - $272,700 a year
- Hospital
- Mid-level
- 3 years
9d
Compliance Officer
AIDS Healthcare Foundation —Los Angeles, CA
- $155,000 - $165,000 a year
- HIPAA
- Senior level
- Health insurance
Quick Apply
Claims Quality Auditor
UCLA Health —Los Angeles, CA
- $31.51 - $62.64 an hour
- Computer literacy
- Research
- Mid-level
Risk Adjustment Compliance Specialist, Principal
Blue Shield of California —Oakland, CA
- $148,940 - $223,300 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Work from home
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)
USC —Los Angeles, CA
- $84,365 - $138,330 a year
- 8 hour shift
- Acute care
- Research
- Mid-level
Licensing Quality Compliance Specialist
UC San Diego Health —San Diego, CA
- $58.91 - $113.89 an hour
- 8 hour shift
- Pass drug screening
- Mid-level
- Bachelor's degree
12d
Regulatory & Compliance HC Specialist 4 - Risk Management FT Days
University of California, Irvine —Orange, CA
- $123,000 - $237,800 a year
- Full-time
- Background check
- RN License
- Customer service
- Health insurance
- Retirement plan
7d
Government Programs Compliance Specialist, Senior
Blue Shield of California —Oakland, CA
- $90,860 - $136,290 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Work from home
Compliance Lead
Fullscript —Riverside, CA
- $125,000 - $160,000 a year
- Email
- Remote
- 7 years
- HIPAA
- Senior level
Quick Apply
Senior Compliance Investigator
UCLA Health —Los Angeles, CA
- $108,900 - $241,500 a year
- Master's degree
- Databases
- Analysis skills
Compliance Coordinator
Coast Medical Service - Internal —Hermosa Beach, CA
- $50,000 - $60,000 a year
- Travel nursing
- Remote
- Pass drug screening
- Mid-level
- Organizational skills
- Disability insurance
- Health insurance
Quality and Compliance Analyst
By the Bay Health —San Mateo, CA
- $36 - $40 an hour
- Full-time
- Mid-level
- Office
- Bachelor's degree
Quick Apply
Compliance Manager
Radiology Partners Inc —California
- $110,000 - $130,000 a year
- Full-time
- HIPAA
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Officer, Ethics & Compliance, Revenue Cycle
Sutter Health —Sacramento, CA
- $148,824.00 - $291,012.80 a year
- Weekends as needed
- Microsoft Excel
- Writing skills
- 11+ years
- Health insurance
9d
Lead Claims Compliance Coordinator
Choice Physicians Network Inc —San Bernardino, CA
- $68,000 - $88,400 a year
- Full-time
- Hybrid work
- Analysis skills
- Neurology
- Senior level
Quick Apply

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healthcare compliance jobs near california

Compliance Investigator II

Partnership HealthPlan of California -
Fairfield, CA

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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

healthcare compliance jobs in california

Compliance Investigator II

Compliance / QA / Revenue Integrity Manager

Call Center Quality Assurance Auditor

Compliance Manager (Remote)

Laboratory Quality & Compliance Safety Specialist - West Valley Hospital

Compliance Officer

Claims Quality Auditor

Risk Adjustment Compliance Specialist, Principal

Compliance Analyst

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

Licensing Quality Compliance Specialist

Regulatory & Compliance HC Specialist 4 - Risk Management FT Days

Government Programs Compliance Specialist, Senior

Compliance Lead

Senior Compliance Investigator

Compliance Coordinator

Quality and Compliance Analyst

Compliance Manager

Officer, Ethics & Compliance, Revenue Cycle

Lead Claims Compliance Coordinator

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