RN II - Delegation Oversight & Compliance Auditor
L.A. Care Health Plan
L.A. Care Health Plan is seeking a Delegation Oversight Clinical Auditor RN II in Los Angeles, California. The role involves ensuring compliance with Utilization Management regulations and performing various audits. Applicants must possess an Associate's Degree in Nursing and be a licensed RN in California, along with at least 7 years of clinical experience, including managed care. The position comes with a competitive salary range and a comprehensive benefits package including paid time off, tuition reimbursement, and wellness programs. #J-18808-Ljbffr L.A. Care Health Plan
- Working Nurse is hiring for the RN Job: Delegation Oversight Clinical Auditor RN II in Los Angeles. This full-time position focuses on ensuring compliance with Utilization Management regulatory requirements through audits and liaisons between Plan Partners and L.A. Care...SuggestedFull time
$88.85k
RN Job: Delegation Oversight Clinical Auditor RN II Shift: Full Time Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Job ID: 130... ...(UM) functions on behalf of L.A. Care (LAC) are in compliance with all UM regulatory requirements and new legislation...SuggestedFull timeShift work$88.85k
...net required to achieve that purpose. Job Summary The Delegation Oversight Clinical Auditor RN II is responsible for ensuring that delegates contracted... ...(UM) functions on behalf of L.A. Care (LAC) is in compliance with all UM regulatory requirements and new legislation...Suggested- ...leading healthcare organization is seeking an Appeals and Grievances Quality Assurance and Auditing Specialist II to oversee audit processes and ensure compliance with regulatory guidelines. This full-time position in Los Angeles emphasizes quality review and improvement...SuggestedFull time
$90k - $100k
...organizational processes and management systems for compliance with applicable ISO requirements... ...steps toward independent thirdparty auditor status Your Qualifications ~ Bachelor... ...in the implementation, maintenance, or oversight of ISO-based management systems...SuggestedPermanent employmentFull timeContract workFreelanceLocal area- Working Nurse is seeking a Utilization Management Claims Review Nurse RN II in Los Angeles. This full-time position involves clinical review of medical claims to ensure services are warranted and compliant with regulations. The ideal candidate will have at least 5 years...Full time
- A leading health coverage provider in Los Angeles is seeking a Customer Engagement and Experience Quality Assurance Auditor II to monitor quality performance in the Contact Center. This role involves auditing processes, creating performance reports, and recommending improvements...Full time
$88.85k - $142.17k
L.A. Care Health Plan is seeking a Clinical Policy Nurse RN II in Los Angeles, CA. This position involves researching and evaluating healthcare policies related to regulatory compliance and health outcomes. The ideal candidate will have over 5 years in Clinical Nursing...Full time- Working Nurse in Los Angeles is seeking a Clinical Policy Clinical Coder RN II to ensure accurate medical coding and compliance with regulations. The role requires collaboration with stakeholders to implement policies and oversee utilization management. The ideal candidate...Full timeShift work
$4,470 - $5,330 per month
...Working Title: Staff Services Management Auditor Classification: STAFF SERVICES... ...funds. This division conducts financial and compliance audits of state and local government agencies... ...Maintenance and Rehabilitation; Local Oversight - Underground Storage Tanks; Peace Officer...Permanent employmentFull timeWork at officeLocal areaRemote work$44.67 - $74.44 per hour
...Infusion Nurse II An Infusion Nurse II is a licensed registered... ...safety with continuity and compliance under a physician's plan of care... .... Effectively provides oversight and coordination of paraprofessionals... ...Active and unrestricted RN license in the state of practice...Local areaFlexible hours$45.16 - $66.4 per hour
...New Grad RN II-ER/FT/Days Job Category: Registered Nurse Requisition Number: NEWGR... ...family teaching and provides leadership by delegating and working cooperatively and... ...patient rights policy; complies with the compliance program; demonstrates knowledge of role...Hourly payFull timeRelocation packageShift workWeekend work$125k - $140k
...Sr. Manager - Claims Delegation Audit The Senior Claims Manager, Claims Delegation Oversight, is responsible for the management and oversight of all Claims Delegation... ...and accuracy of the claims process and ensure compliance with regulations and contract requirements for...Contract workWork at office- ...Clinical Operations Coordinator II, RN Join Cedars-Sinai! Cedars-Sinai is #1 in California and has been named to the Honor Roll for... ...processes and procedures per CSMCF policies. Monitors staff compliance with professional licenses and certifications including CPR...Work experience placementWork at officeShift work
- MedPOINT Management is seeking a Hospital Claims Auditor responsible for ensuring the quality of claims processes and compliance with health plan and hospital regulations. The role involves auditing claims, conducting training, and suggesting process improvements. Candidates...Remote work
$115.44k - $148.15k
Sr. Manager - Claims Delegation Audit Department: Ops - Claims Ops Employment Type: Full... ...Senior Claims Manager, Claims Delegation Oversight, is responsible for the management and... ...of the claims process and ensure compliance with regulations and contract requirements...Full timeContract workWork at office$42.04 - $65.27 per hour
...Description Providence is calling for Revenue Cycle Auditor RN - Full time, Day, Remote The Revenue Cycle Auditor is responsible for providing patient focused, standardized, compliant revenue cycle support that will assist Providence St Joseph Health in meeting...Minimum wageFull timeLocal areaRemote workShift work- ...Customer Solution Center Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the guidelines and protocols to ensure... ...for the ongoing progression and maintenance of CSC's compliance program efforts, including, but not limited to,...
$141.97k - $156.55k
...Transplant Coordinator II - RN Join Us in Transforming Lives Every Day At OneLegacy, every moment counts. As the nation's largest... ...about organ, eye and tissue donation. PTC-IIs are delegated the administrative authority, responsibility, and accountability...Full timeWork at officeShift workNight shift- ...Report (SAR) form and narrative once it has been approved by the Compliance Officer. Ensure all SAR filings are e‑filed via the BSA... ...files of all BSA transmissions and documents required by IRS auditors readily available. Assist the Cage and Floor Personnel with any...Work experience placement
$33 - $54.2 per hour
...Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy...Hourly payFull timeContract workWork at office$120 - $140 per hour
Position overview Monitor and ensure dealer compliance with PAG/PCNA’s policies and procedures. The auditor present the audit findings to the Porsche Centers. The auditor will communicate best practices and act as trusted advisor to the Porsche Center. Responsible to perform...Work experience placementWork at office- Hustler Casino is seeking a Compliance Officer to oversee procedures related to Currency Transaction Reports (CTR) and ensure adherence to Title 31 compliance regulations. The ideal candidate will have a high school diploma or GED, strong organization skills, and at least...
- ...integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required Licenses/Certifications: Inpatient -...
- A prestigious automotive manufacturer in Los Angeles seeks a Compliance Auditor to ensure dealer adherence to policies and procedures. The role involves performing audits, writing compliance reports, and providing training to dealership personnel. Candidates should have...
- Mattel is seeking a Senior Internal Auditor to support the company’s Sarbanes-Oxley (SOX) compliance program. You will conduct SOX control testing, assess effectiveness of controls, and work closely with global audit teams. Candidates should have a bachelor’s degree in...
- ...SOX Compliance Auditor A leading digital streaming network seeks an SOX Compliance Auditor to support Internal Controls and SOX Compliance testing activities. This role focuses on executing control testing, assessing control effectiveness, and delivering high-quality...Flexible hoursShift work
- ...SOX Compliance Auditor Execute SOX key control testing for the Internal Controls / SOX Compliance program. Responsibilities include independently performing control testing, evaluating control design and operating effectiveness, and clearly documenting test procedures...
$133.13k
Auditor - Assurance - FAAS - FSO - Manager - Multiple Positions - 1710461 Other locations: Primary Location Only Date: 19 May 2026... ...&A activity, undertaking an IPO or facing other regulatory or compliance matters on business, operational, and financial matters. Address...Full timeTemporary workWork experience placementSummer holidayLocal areaMonday to Friday$104.8k - $128k
The Walt Disney Company (France) is seeking a Senior IT Auditor in Glendale, California. This role focuses on executing and leading... ...Candidates should have a minimum of 2 years in IT audit or SOX compliance, strong analytical skills, and knowledge of IT governance frameworks...
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