Top 619 Operations representative Jobs in Fairfield, Ca

Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $96,970.04 - $121,212.56 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
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
Training Specialist
Partnership HealthPlan of California —Fairfield, CA
- $88,154.59 - $110,193.23 a year
- Full-time
- Computer literacy
- Research
- Mid-level
- Wellness program
Process Tech I - 1st Shift(Onsite)
Collins Aerospace —Fairfield, CA
- $35,537 - $66,651 a year
- Overtime
- Microsoft Word
- High school diploma or GED
- Math
- Paid holidays
- Loan repayment program
Executive Assistant
Northbay Healthcare —Fairfield, CA
- $38.91 an hour
- Full-time
- Hybrid work
- Microsoft Outlook
- Customer service
- Writing skills
- 403(b) matching
- Health insurance
10d
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Full-time
- Research
- Mid-level
- Office
Field Account Representative
W.W. Grainger —Napa, CA
- $59,500 - $89,300 a year
- Hybrid work
- High school diploma or GED
- Driver's License
- Experience equivalent to degree accepted
- Paid parental leave
- Dental insurance
6d
Refrigeration Sales Representative
Cold Temp Solutions —Martinez, CA
- From $80,000 a year
- Full-time
- Background check
- Clean driving record
- Sales
- Profit sharing
- Health insurance
Quick Apply
Human Resources Generalist - ON-SITE
Gold Star Foods —Dixon, CA
- $70,000 - $80,000 a year
- Full-time
- Spanish
- 5 years
- Bachelor of Science
Quick Apply
Physician Assistant, Ortho Surgical (Full Time, Days)
Northbay Healthcare —Vacaville, CA
- $88.42 - $107.45 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Surgery
Lead Teacher
Child Start Inc. —Vallejo, CA
- $27.53 - $31.09 an hour
- Full-time
- Classroom
- Spanish
- CPR Certification
- Paid holidays
- Health insurance
Quick Apply
Standby Utility/Gas Inspector
Alisto Engineering Group —Walnut Creek, CA
- From $74.61 an hour
- Overtime
- Background check
- Clean driving record
- Customer service
- Paid training
- Health insurance
Quick Apply
Supervisor of Utilization Management
Partnership HealthPlan of California —Fairfield, CA
- $141,067.17 - $183,387.32 a year
- Full-time
- Nursing
- RN License
- Customer service
Massage Therapist at Luxury Hotel
LAFAYETTE PARK HOTEL & SPA —Lafayette, CA
- $16.90 - $35.00 an hour
- Full-time
- CPR Certification
- Anatomy knowledge
- BLS Certification
- Health insurance
- Dental 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
Preschool Center Director
Child Start Inc. —Napa, CA
- $5,677.30 a month
- Full-time
- Spanish
- CPR Certification
- Clean driving record
- Health savings account
- Health insurance
Quick Apply
Regional Speech Language Pathologist (SLP)
Spectrum Center Schools and Programs —Solano County, CA
- $110,000 - $125,000 a year
- Full-time
- Background check
- School experience
- Writing skills
- Wellness program
- Mileage reimbursement
Quick Apply
ASSISTANT DIRECTOR OF CHILD NUTRITION SERVICES
Pittsburg Unified School District —Pittsburg, CA
- $56.34 - $64.53 an hour
- Overtime
- Background check
- School experience
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
8d
Machinist IV
Benchmark Electronics, Inc —Concord, CA
- $41.35 - $62.03 an hour
- 8 hour shift
- Writing skills
- 8 years
- High school diploma or GED
- Dental insurance
- 401(k)
Machinist IV
Benchmark Electronics, Inc —Concord, CA
- $41 - $52 an hour
- Email
- Writing skills
- Pass drug screening
- 8 years
- Dental insurance
- 401(k)

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operations representative jobs near fairfield, ca

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

operations representative jobs in fairfield, ca

Compliance Investigator II

Claims Customer Service Representative I

Training Specialist

Process Tech I - 1st Shift(Onsite)

Executive Assistant

Claims Examiner II

Field Account Representative

Refrigeration Sales Representative

Human Resources Generalist - ON-SITE

Physician Assistant, Ortho Surgical (Full Time, Days)

Lead Teacher

Standby Utility/Gas Inspector

Supervisor of Utilization Management

Massage Therapist at Luxury Hotel

Property Manager - Vacaville, CA

Preschool Center Director

Regional Speech Language Pathologist (SLP)

ASSISTANT DIRECTOR OF CHILD NUTRITION SERVICES

Machinist IV

Machinist IV

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