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Bee Talent Solutions
Carpinteria, CA, United States
We are seeking a strong SOX Compliance Analyst to manage a 6-month project for our client in their new GRC platform including updating control information, tracking project status, and reporting on timelines and milestones. This position will report to the Sr. Manager of Compliance. Responsibilities: Obtain and review evidence for SOX IT general
Job Source: Bee Talent SolutionsMotion Recruitment Partners, LLC
Carpinteria, CA, United States
Leader in their industry, our exciting global SaaS construction platform client seeks a contract Compliance Analyst (SOX). This is fully remote position. Seeking a strong SOX Compliance Analyst to manage a 6-month project in our new GRC platform including updating control information, tracking project status, and reporting on timelines and milesto
Job Source: Motion Recruitment Partners, LLCCenCal Health
Santa Barbara, CA, United States
Job Details Job Location : Main Office - Santa Barbara, CA Position Type : Full Time Salary Range : Undisclosed Job Category : Compliance Description Salary Range: $101,007 - $151,510 Job Summary The Compliance Strategist will lead the AMO in meeting regulatory requirements and business objectives through program develop
Job Source: CenCal HealthPayJunction
Santa Barbara, CA, United States
Job Description Job Description We are seeking a Director of Compliance to join our organization to help orchestrate and oversee the various company compliance audits, ensuring all departments adhere to the applicable, respective compliance standards (in a timely manner), and to assist in the drafting and review of corporate Governance, Risk, a
Job Source: PayJunctionMotion Recruitment Partners
Carpinteria
Compliance Analyst (SOX) Carpinteria, California **100% Remote** Contract $57.67/hr - $57.67/hr Leader in their industry, our exciting global SaaS construction platform client seeks a contract Compliance Analyst (SOX). This is fully remote position. Seeking a strong SOX Compliance Analyst to manage a 6-month project in our new GRC platform includin
Job Source: Motion Recruitment PartnersKimpton Hotel
Santa Barbara, CA, United States
Why We're HereWe believe heartfelt, human connections make people's lives better. Especially the people who work here. Our founder, Bill Kimpton rebelled against impersonal, generic hospitality that makes people feel disconnected. He initiated a new boutique hotel standard and environment where people could connect, from the heart. That was the goa
Job Source: Kimpton HotelStantec
Santa Barbara, CA, United States
Environmental Compliance Specialist - ( 230002YJ ) Description Grounded in safety, quality, and ethics, our experts lead their fields and guide our work with rigor, a creative spirit, and vision for growth. We draw from more than 20 technical specialties around the globe and are committed to fostering an inclusive community of diverse talents, ba
Job Source: Stantecergomotion®
Goleta, CA, United States
Ergomotion, the leading global sleep experience company, is looking for an experienced, dynamic and detail-oriented Customs Compliance Specialist. In this role you will ensure compliance with US Customs, transportation limitations and regulations and effectively manage ocean and transportation costs. Position Objective: Under general guidance,
Job Source: ergomotion®Santa Barbara, CA, United States
Job Details
Job Location
Main Office - Santa Barbara, CA
Position Type
Full Time
Job Category
Compliance
Description
California Salary Range: $82,165 - $119,140
Job Summary
Under the direction and supervision of the Audit Manager within the Audits, Monitoring, & Oversight Department of the Compliance Division, and through collaboration with Directors and Management level staff, this position conducts audit activities of varying complexity and supports initiatives of moderate to complex difficulty related to CenCal Health's audits, monitoring, and oversight program. This includes the performance of routine and complex audit, monitoring, and oversight activities of internal departments and external partners to ensure compliance with State and Federal regulatory and contractual requirements, and operational plan requirements, as well as assisting in writing, reviewing, and coordinating remediation and corrective action plans.
Duties & Responsibilities
Using clinical experience and expertise, conduct routine and complex compliance audit activities (e.g., reviewing of medical records) of internal departments and external partners, documenting results in audit work papers, developing detailed document request lists, conducting audit conferences and walk-throughs, and proposing recommendations for improvement.
Review documented clinical processes against contractual, Federal, and State requirements, as well as NCQA standards.
Conduct regulatory research to identify gaps and provide an interpretation of clinical requirements and regulations to ensure appropriate application of medical and clinical criteria.
Develop audit scope and maintain audit tools based on regulatory compliance with DHCS, DMHC, and CMS requirements, as well as NCQA standards.
Able to write clear and concise audit reports based on audit results, ensuring accuracy and quality of audit reporting and utilizing clinical knowledge to determine findings.
Assist in development and implementation of quality improvement, remediation plans (RPs), and corrective action plans (CAPs) based on risk analysis, audit findings, or delegate performance, to ensure evidence of corrective actions is in place.
Assist in the maintenance of CenCal Health's risk logs and audit tools.
Using clinical experience and expertise, conduct routine monitoring activities to ensure compliance with regulatory and contractual requirements.
Create reports and analyze data for reporting to management, the Delegation Oversight Committee, Compliance Committee, and Board of Directors.
Prepare and send out audit announcement memos.
Prepare audit programs and conduct audits of assigned areas, including performing various audit procedures and documenting audit findings.
Perform and coordinate follow-up audits to determine if management has taken action to mitigate the risks identified.
Provide independent evaluations and assist with the maintenance of operational controls, tools, policies, and procedures.
Assist and support the development of materials for audit Entrance and Exit conferences.
Train internal audit participants/ business owners on audit process and/or tools.
Comply with HIPAA, Privacy, and Confidentiality laws and regulations.
Other duties as assigned.
Qualifications
Knowledge/Skills/Abilities
Required: Audit experience with DHCS, CMS, DMHC, and/or NCQA and an understanding of clinical audit standards and requirements;
Excellent written and verbal communication skills with strong business writing aptitude;
Experience researching, compiling, and organizing information from various sources;
Strong organizational skills and attention to detail;
Strong skills in problem identification, analysis, resolution, organization, and prioritization;
Demonstrate ability to accurately apply and interpret clinical guidelines;
Ability to reprioritize workload as needed;
Ability to work productively with all Plan staff;
Ability to coordinate work between departments;
Ability to work with minimal supervision, both independently and in teams;
Attention to detail and accuracy.
Desired: Certified Internal Auditor (CIA), Certified Health Care Compliance (CHC), Certified Healthcare Auditor (CHA), CHIAP (Certified Healthcare Internal Audit Professional) preferred or ability to achieve certification within 1 year.
Experience in health care compliance.
Education & Experience Advanced degree, Bachelor's preferred or equivalent experience in clinical field.
Current active, unrestricted, California Registered Nurse (RN) and/or Nurse Practitioner (NP) License.
2+ years of (a)combined clinical and compliance experience or (b) auditing experience in a healthcare environment.
Email Alert for Compliance Nurse Auditor jobs in Santa Barbara, CA, United States
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