Top 188 Compliance Jobs in Detroit Mi

Auditor, Healthcare Services (Remote in MI)
Molina Healthcare —Detroit, MI
- $26.41 - $51.49 an hour
- Full-time
- Remote
- Microsoft Excel
- RN License
- LPC
- Health insurance
Data Entry & Compliance Specialist
GDI Services Inc US —Southfield, MI
- Customer service
- Research
- Office
Quick Apply
Compliance Senior Analyst
Blue Cross Blue Shield of Michigan —Detroit, MI
- Full-time
- Mid-level
- Office
- Bachelor's degree
5d
Specialist, Risk and Compliance Services (Onboarding)
Deloitte —Detroit, MI
- $63,000 - $116,000 a year
- Full-time
- Microsoft Word
- Mid-level
- 3 years
Compliance Site Manager
Henry Ford Health —Detroit, MI
- Day shift
- Hospital
- Mid-level
- Bachelor's degree
- Health insurance
- Dental insurance
Compliance Specialist II
AAA Life Insurance Company —Livonia, MI
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
- Life insurance
Research Compliance Program Specialist, Division of Research & Innovation
Wayne State University —Detroit, MI
- Full-time
- Background check
- Management
- Office
Sr. Manager, Customs & Trade Compliance
Vibracoustic USA Inc. —Farmington Hills, MI
- 5 years
- Master's degree
- Bachelor's degree
- Paid holidays
- Health insurance
3d
Clinical Compliance AND Operations Auditor
Centria Autism —Dearborn, MI
- $95,000 - $110,000 a year
- Full-time
- Doctoral degree
- Computer literacy
- Writing skills
Quick Apply
4d
Local Counsel/Per Diem Attorneys
Court Appearance Professionals —Michigan
- $60 - $175 an hour
- Contract
- Mid-level
- In-person
- Flexible schedule
Quick Apply
9d
Regulatory Affairs Specialist I
Getinge —Fraser, MI
- $75,280 - $94,100 a year
- Extended hours
- Microsoft Word
- Engineering
- Office
- Commuter assistance
- Disability insurance
Sr Coor-Research Compliance- Full time - Research Administration
Henry Ford Health —Detroit, MI
- Full-time
- Office
- Master's degree
- Bachelor's degree
- Health insurance
- Dental insurance
Integrity & Compliance Program Manager
Trinity Health —Livonia, MI
- $47.23 - $70.85 an hour
- Full-time
- 5 years
- Supervising experience
- Bachelor's degree
Commercial Vehicle Center Compliance Coordinator
Ford Motor Company —Detroit, MI
- Full-time
- Hybrid work
- Office
- Travel
- Organizational skills
5d
Compliance Manager
Genisys Credit Union —Auburn Hills, MI
- 8 hour shift
- Hybrid work
- 5 years
- Office
- Finance
- Paid holidays
- Disability insurance
Director - Compliance Consulting
WTW —Detroit, MI
- $95,000 - $165,000 a year
- Full-time
- Management
- HIPAA
- Bachelor's degree
- Paid jury duty
- Health savings account
Junior Compliance Officer/Auditor
SGI Global, LLC —Detroit, MI
- 8 hour shift
- Bachelor of Science
- Research
- Finance
Quick Apply
COMPLIANCE ANALYST
Full Circle Communities —Detroit, MI
- $75,000 - $82,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Office
- Paid parental leave
- Paid holidays
Quick Apply
2d
Auditor, Social Responsibility (Social Compliance Auditor)
Carhartt —Dearborn, MI
- Overtime
- Spanish
- English
- Research
Specialist, Risk and Compliance Services (DESC)
Deloitte —Detroit, MI
- $63,000 - $116,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- 3 years
4d

I want to receive the latest job alert for compliance in detroit mi

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Auditor, Healthcare Services (Remote in MI)

Molina Healthcare -
Detroit, MI

Apply Now

Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION

This position will offer remote work flexibility, but the selected candidate must reside in Michigan.

Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with Waiver Program is vital to success in this role.

The preferred candidate will have 3 – 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Licensure should be an LPC, RN, LLMSW, LMSW, LBSW.

Hours are Monday – Friday, 8:30AM – 5PM EST.

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
Adheres to departmental standards, policies and protocols.
Maintains detailed records of auditing results.
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards related to clinical auditing.
May conduct staff trainings as needed. • Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.

Required Qualifications

At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.

Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.

Strong attention to detail and organizational skills.

Strong analytical and problem-solving skills.

Ability to work in a cross-functional, professional environment.

Ability to work on a team and independently.• Excellent verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

compliance jobs in detroit mi

Auditor, Healthcare Services (Remote in MI)

Data Entry & Compliance Specialist

Compliance Senior Analyst

Specialist, Risk and Compliance Services (Onboarding)

Compliance Site Manager

Compliance Specialist II

Research Compliance Program Specialist, Division of Research & Innovation

Sr. Manager, Customs & Trade Compliance

Clinical Compliance AND Operations Auditor

Local Counsel/Per Diem Attorneys

Regulatory Affairs Specialist I

Sr Coor-Research Compliance- Full time - Research Administration

Integrity & Compliance Program Manager

Commercial Vehicle Center Compliance Coordinator

Compliance Manager

Director - Compliance Consulting

Junior Compliance Officer/Auditor

COMPLIANCE ANALYST

Auditor, Social Responsibility (Social Compliance Auditor)

Specialist, Risk and Compliance Services (DESC)

I want to receive the latest job alert for compliance in detroit mi

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected