Top 209 Internal affair investigator 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
Deputy Coordinator, Investigation and Resolution
USC —Los Angeles, CA
- $111,276 - $180,250 a year
- 5 years
- Master's degree
- University
INVESTIGATOR
Department of Social Services —Butte County, CA
- $6,339 - $10,609 a month
- Full-time
- Hybrid work
- Background check
- Research
- Mid-level
- Paid holidays
- Health insurance
13d
Associate Director, Real-World Evidence & Epidemiology
Natera —San Francisco, CA
- $176,000 - $220,000 a year
- Remote
- 7 years
- Analysis skills
- Doctor of Philosophy
- Commuter assistance
- Health insurance
Health Educator 3
University of California San Francisco —San Francisco, CA
- Full-time
- Writing skills
- Mid-level
- 3 years
12d
Regulatory Affairs Specialist II
City of Hope —Duarte, CA
- $40.82 - $63.27 an hour
- Full-time
- Mid-level
- Master's degree
- Bachelor's degree
DISTRICT ADMINISTRATOR, ALCOHO
Department of Cannabis Control —Sacramento County, CA
- $9,869 - $13,497 a month
- Online Application
- Hybrid work
- Management
- Residential
- Driver's License
10d
Sponsored Programs Analyst - Post Award
California State University —East Bay, CA
- Full-time
- Background check
- Mid-level
- Office
- Paid holidays
- Health insurance
Quality Investigator
B. Braun US Pharmaceutical Manufacturing LLC —Irvine, CA
- $71,169 - $89,000 a year
- Engineering
- Analysis skills
- Senior level
- Health insurance
- 401(k)
Junior Specialist - Division of General Internal Medicine
University of California, Davis —Davis, CA
- $26.35 - $28.07 an hour
- Multiple hires
- Microsoft Excel
- Microsoft Outlook
- Internal Medicine
Clinical Research Coordinator
University of California San Francisco —San Francisco, CA
- HIPAA
- Mid-level
- High school diploma or GED
Assistant Regulatory Affairs Coordinator - Hybrid
University of California, Irvine —Orange, CA
- $31.11 - $51.25 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Retirement plan
Translational Research Scientist
Intuitive —Sunnyvale, CA
- Full-time
- Remote
- Medicine
- Surgery
- 5 years
Quick Apply
Quality Assurance Coordinator - Hybrid
University of California, Irvine —Orange, CA
- $33.04 - $57.88 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Retirement plan
What We Offer:
CliniRx —California
- Remote
- Master's degree
- Analysis skills
- Bachelor's degree
Lead Deputy Title IX Coordinator
Pomona College —Claremont, CA
- $96,000 - $113,000 a year
- Full-time
- Writing skills
- Mid-level
- Residential
Senior Clinical Scientist, ECD
Natera —San Francisco, CA
- $142,800 - $178,500 a year
- Remote
- Medicine
- 6 years
- Analysis skills
- Commuter assistance
- Health insurance
Title IX Coordinator and Student Affairs Case Manager
Otis College of Art and Design —Los Angeles, CA
- $91,731 - $112,794 a year
- 5 years
- Residential
- Analysis skills
- Disability insurance
10d
Sr. Manager, Medical Writing (Remote)
Artiva Biotherapeutics —San Diego, CA
- $165,000 - $180,000 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Doctor of Philosophy
- Paid holidays
- Disability insurance
Quick Apply
Clinical Research Regulatory Specialist
USC —Los Angeles, CA
- $75,968.95 - $81,000.00 a year
- HIPAA
- Mid-level
- Administrative experience
13d

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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

internal affair investigator jobs in california

Compliance Investigator II

Deputy Coordinator, Investigation and Resolution

INVESTIGATOR

Associate Director, Real-World Evidence & Epidemiology

Health Educator 3

Regulatory Affairs Specialist II

DISTRICT ADMINISTRATOR, ALCOHO

Sponsored Programs Analyst - Post Award

Quality Investigator

Junior Specialist - Division of General Internal Medicine

Clinical Research Coordinator

Assistant Regulatory Affairs Coordinator - Hybrid

Translational Research Scientist

Quality Assurance Coordinator - Hybrid

What We Offer:

Lead Deputy Title IX Coordinator

Senior Clinical Scientist, ECD

Title IX Coordinator and Student Affairs Case Manager

Sr. Manager, Medical Writing (Remote)

Clinical Research Regulatory Specialist

I want to receive the latest job alert for internal affair investigator in california

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