- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Quality Audit Professional 2 analyzes and investigates quality issues. The ... Quality Audit Professional 2 work assignments are varied and frequently require...independent determination of the appropriate courses of action. The Quality Audit Professional 2 supports… more
- Datavant (Springfield, IL)
- …the QA team, driving professional development and team accountability. The QA Audit teams currently oversee digital fulfillment, the quality portion of the ... life experiences to realize our bold vision for healthcare. We are seeking a QA Audit Manager to lead Datavant's Quality Assurance Audit function. This role… more
- Western Digital (Springfield, IL)
- …and consumers alike under our Western Digital(R), WD(R), WD_BLACK (TM) , and SanDisk(R) Professional brands. We are a key partner to some of the largest and ... future of data storage. **Job Description** The Manager, IT Audit , will play a key role within Western Digital's...accurate in AuditBoard in accordance with IA methodology and professional standards. Risk & Governance + Partner with Enterprise… more
- Coinbase (Springfield, IL)
- … team is responsible for strategic analysis, risk assessments, development of the audit plan, project management, quality review, report issuance and issue ... and offshore resources, across multiple time zones. Set performance standards, ensure high- quality deliverables, and drive timely execution of audit and… more
- WelbeHealth (Springfield, IL)
- …and Related Entity (FDR) compliance + Collaborate with operational, clinical, and quality leadership to ensure that audit findings drive enterprise-wide ... with a minimum of five (5) years interacting with audit activities in a healthcare setting + Professional... audit activities in a healthcare setting + Professional certifications such as Certification in Healthcare Compliance (CHC),… more
- Health Care Service Corporation (Springfield, IL)
- …be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for auditing operations ... to include Word, Access, Excel and Cognos. **Preferred Job Qualifications:** + Audit experience and knowledge of Accreditation (ie NCQA, URAC, etc.) + Knowledge… more
- Coinbase (Springfield, IL)
- …experience in coding languages such as Python, Ruby, etc. *Nice to haves:* * Professional Internal Audit / IT / Security qualification (eg, CISA, CFE, etc.) ... and fully supported. Coinbase is looking for an Internal Audit Senior, IT to join the Internal Audit...analytical and problem solving skills, with high standards for quality , accuracy and attention to detail. * Excellent written… more
- Datavant (Springfield, IL)
- …complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for ... healthcare. As an **ProFee Audit Specialist** you will be instrumental in addressing consulting...in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim… more
- Datavant (Springfield, IL)
- …complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for ... instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, and coding… more
- Datavant (Springfield, IL)
- …complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for ... in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding… more
- Humana (Springfield, IL)
- …throughout the enterprise on significant healthcare compliance topics. The Compliance Professional leads incoming regulatory audits, coordinates audit responses, ... health first** Humana Dual Fully Integrated (HMO D-SNP) is seeking a Compliance Professional to monitor key metrics, risks and privacy events to determine weaknesses… more
- ABBTECH Professional Resources, Inc. (Springfield, IL)
- …Group Services, Inc., we pride ourselves on delivering unparalleled service quality , coupled with a client-focused approach that ensures responsiveness and lasting ... impactful financial projects and drive organizational success. **Essential Functions** **_1. Audit Projects_** **?** Variety **of Audits:** + Conduct various types… more
- CVS Health (Springfield, IL)
- …+ Experience with NCQA Health Plan survey preparation and submission + Certified Professional in Healthcare Quality (CPHQ) **Education** + Bachelor's degree in ... in Illinois Must hold a Clinical License** The Manager of Health Care Quality will support the functions of the Illinois Fully Integrated Duals Eligible (FIDE)… more
- Humana (Springfield, IL)
- …community and help us put health first** The Medicaid Process Improvement Professional 2 is responsible for analyzing and evaluating the effectiveness of existing ... addressing operational inefficiencies, system discrepancies, or member-level variances. The professional collaborates closely with cross-functional teams, including state agencies,… more
- Humana (Springfield, IL)
- …caring community and help us put health first** The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The ... Senior Risk Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… more
- Humana (Springfield, IL)
- …caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects anomalies in data to identify and ... of fraud waste and our financial recovery. The Senior Payment Integrity Professional work assignments involve moderately complex to complex issues where the analysis… more
- CVS Health (Springfield, IL)
- …all with heart, each and every day. **Position Summary** Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and ... experience equal to approximately 1-2 years for CPC. + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required. + CRC (Certified… more
- Parexel (Springfield, IL)
- …of assigned clinical trials investigator sites to ensure patient safety and quality study execution in accordance with applicable prevailing laws, Good Clinical ... clinical trials (eg enrollment, database release), to safeguard the quality of investigator sites (eg patient safety, site ...applicable + Serve as a point of contact for audit conduct, and drive Audit Observation corrective… more
- CBRE (Springfield, IL)
- …estate portfolio administration, database management, accounts payable and receivable, and audit services. **What You'll Do:** + Compare and evaluate operating ... clients. Request additional information and recommend action for additional audit and recovery. + Prepare complex reports of findings...May convince to reach an agreement. + Impact the quality of own work and the work of others… more
- Sysco (Lincoln, IL)
- …(GFSI), audits by BRC, independent third parties, customers, and Sysco's internal audit process, analyze results, determine root cause, and gather corrective action ... plans for audit non-conformance(s). Reviews results with Field Food Safety Director. Acts as the site's primary contact during Food Safety regulatory authority… more