- LA Care Health Plan (Los Angeles, CA)
- …Education Preferred Experience Required: A minimum of 5 years of experience in regulatory auditing ( Appeals & Grievances , Call Center, Enrollment) in ... Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA,...verified through reconciliation of end to end on all regulatory functions. Duties Audit readiness: Performs … more
- LA Care Health Plan (Los Angeles, CA)
- …is the liaison in external and or (CMS) claim audits Organization Determination, Appeals & Grievances (ODAG) of delegates and subsequently monitors delegates ... Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance...reviewed and approved by management prior to submission for Regulatory Affairs & Compliance and Legal review. Monitors the… more
- LA Care Health Plan (Los Angeles, CA)
- …care setting. Experience in health care auditing and monitoring (preferably in Appeals , Grievances , Quality Improvement, Utilization Management (UM) and so ... compliant with all Product Lines' contractual, state and federal regulatory , and accreditation requirements. The Compliance Advisor develops ...forth) and developing audit tools. Demonstrated experience developing and delivering training programs… more