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Rso Compliance Coordinator
1 week ago
USC Los Angeles, United StatesThe RSO Compliance Coordinator is part of the Campus Activities team and reports to the Assistant Director of Campus Activities, Campus Activities plays a key leader within USC Student Life and the University. The Campus Activities department has a significant impact on the stude ...
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Regional Compliance Coordinator
1 week ago
WinnCompanies Los Angeles, United StatesWinnCompanies is searching for a Regional Compliance Coordinator to join our corporate Compliance team. · In this role, you will be responsible for ensuring that all policies and procedures from Winn and Affordable Housing agencies are communicated to, and implemented by, site ma ...
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Benefits and Compliance Coordinator
2 days ago
Riboli Family Wines Los Angeles, United StatesBuild your career at Riboli Family Wines Riboli Family Wines is of the fastest-growing wine manufacturers in the U.S. and has received the designation of American Winery of the Year. We are a family-owned business, four generations deep, with 100+ years of producing well-known wi ...
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Rrh and Hp Compliance Coordinator
1 week ago
Illumination Foundation Anaheim, United States**_"Every person deserves compassion, dignity, and the safety of a place to call home."_**: · - Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of h ...
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Compliance Coordinator
2 weeks ago
Health Right 360 Pomona, United StatesHealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment. · **Benefits and perks**: · - HR360 offers ...
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Compliance Coordinator
2 days ago
MedPOINT Management Los Angeles, United StatesJob Description · Job Description · Summary · MedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act ...
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Compliance Coordinator
2 weeks ago
Commodore Offshore Operating, LLC Los Angeles, United StatesThe Compliance Coordinator provides systemic and advisory support to the organization on regulations and compliance involving GOM Shelf LLC assets. This position is expected to oversee and maintain compliance management systems, act as a focal point of communications between gove ...
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Compliance Coordinator
1 week ago
Commodore Offshore Operating Llc Los Angeles, United StatesThe Compliance Coordinator provides systemic and advisory support to the organization on regulations and compliance involving GOM Shelf LLC assets. This position is expected to oversee and maintain compliance management systems, act as a focal point of communications between gove ...
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Compliance Coordinator
3 days ago
MedPOINT Management Los Angeles, United StatesJob Description Job Description SummaryMedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act in accord ...
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Coordinator, Property Compliance
1 day ago
Invitation Homes Pasadena, United StatesWho We Are · Invitation Homes is a team of more than 1,400 associates who come from all walks of life. We call different communities "home," but our shared values bind us together. Invitation Homes is a place where possibility lives. · The market teams include our Leasing, Proper ...
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Compliance Coordinator
2 weeks ago
Core MedStaff Los Angeles, United StatesJob DescriptionJob Description · The Company: · Core MedStaff is a leading provider of per diem and travel nurse professionals in the greater Los Angeles area. We distinguish ourselves through our commitment to quality and integrity in our business practices, our unique appreci ...
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Compliance Coordinator
1 week ago
Core MedStaff Los Angeles, United StatesJob DescriptionJob Description · The Company: · Core MedStaff is a leading provider of per diem and travel nurse professionals in the greater Los Angeles area. We distinguish ourselves through our commitment to quality and integrity in our business practices, our unique appreci ...
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Compliance Coordinator
2 days ago
Core MedStaff Los Angeles, United StatesJob DescriptionJob DescriptionThe Company:Core MedStaff is a leading provider of per diem and travel nurse professionals in the greater Los Angeles area. We distinguish ourselves through our commitment to quality and integrity in our business practices, our unique appreciation fo ...
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Compliance Coordinator
1 week ago
MedPOINT Management Los Angeles, United StatesJob Description · Job DescriptionSummary · MedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act in ac ...
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Compliance Coordinator
1 week ago
Core MedStaff Los Angeles, United StatesJob Description · Job DescriptionThe Company: · Core MedStaff is a leading provider of per diem and travel nurse professionals in the greater Los Angeles area. We distinguish ourselves through our commitment to quality and integrity in our business practices, our unique appreciat ...
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Intersession Compliance Coordinator
6 days ago
Options For Youth Public Charter Schools Duarte, United StatesJob Description · Are you looking for a rewarding summer position working remotely? Do you believe that every student should have the opportunity for success? Well, look no further Options For Youth is actively seeking an Compliance Coordinator and that might be you- Maintain int ...
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RSO Compliance Coordinator
1 week ago
University of Southern California Los Angeles, United StatesThe RSO Compliance Coordinator will play a key role in the management and oversight of the nearly 1000 Registered Student Organizations with special attention to high-risk organizations. Key responsibilities of this position include:Oversight and man Compliance Coordinator, Compl ...
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RSO Compliance Coordinator
2 weeks ago
University of Southern California Los Angeles, United StatesRSO Compliance CoordinatorApply \_REQ /apply) Student Affairs Los Angeles, California · The RSO Compliance Coordinator is part of the Campus Activities team and reports to the Assistant Director of Campus Activities, Campus Activities plays a key leader within USC Student Life a ...
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RSO Compliance Coordinator
2 weeks ago
University of Southern California Los Angeles, United StatesRSO Compliance CoordinatorApply \_REQ /apply) Student Affairs Los Angeles, California · The RSO Compliance Coordinator is part of the Campus Activities team and reports to the Assistant Director of Campus Activities, Campus Activities plays a key leader within USC Student Life an ...
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Benefits and Compliance Coordinator
2 weeks ago
Riboliwines Los Angeles, United StatesThe Human Resource Team is seeking a Benefits and Compliance Coordinator to assist the Senior HR Leadership team with ensuring we are in compliance and up to date with training, benefits and state/federal requirements. This individual should be a self-starter, collaborative, comf ...
Quality Compliance Nurse and Compliance Coordinator - Los Angeles, United States - Preferred IPA of California
Description
Job DescriptionJob Description
Openings for both a Quality Compliance Nurse and a Compliance Coordinator.
QUALITY COMPLIANCE NURSE
PURPOSE:
The Quality and Compliance Nurse is responsible for working with the Medical Director, the VP of Clinical Policy, the QM Committee in developing, implementing, and refining the Quality Management Program.
They are also responsible for oversight and management of Health Plan Audits, as well as responding to Appeals and Grievances.
ESSENTIAL DUTIES:
Organizes and participates in QM Committee meetings. Prepares agenda and meeting minutes. Provides support functions necessary for effective QM Committee processes.
Helps in the development and maintenance of the QM Plan, annual work plan and quarterly reports in conjunction with the QM Committee.
In collaboration with VP of Clinical Policy and Client Health Services Department, identifies quality standards and clinical benchmarks.As part of quarterly reporting, establishes QM processes through tracking and trending of data for identification of under and over utilization.
Coordinates QM functions between Medical Management Department, Physician Group, Health Plan and outpatient care settings assuring quality improvement in clinical care and non-clinical aspects of service.
Provides oversight and management of Health Plan audits including the preparation of all needed documentsTimely review and processing of appeals and UM department grievances according to Medical Management policies and procedures.
Develops and monitors compliance with responses to corrective action plans (CAP) for post health plan audits and regulatory audits.
Acts as liaison to all affiliated health plans.
COMPLIANCE COORDINATOR
The Compliance Coordinator is responsible for supporting the Quality Compliance Nurses for audit preparation. This includes review of audit tool, requesting authorization universes and file preparation for audit submission.
Company Description Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members.
We work with the network's participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment.
We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.Company Description
Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members.
We work with the network's participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment.
We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.#J-18808-Ljbffr