SIU Clinical & Audit Leader
Blue Cross and Blue Shield of North Carolina
Blue Cross NC is seeking a strategic SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting healthcare fraud, waste, and abuse. The role guides prepayment and post-payment medical record reviews, ensures regulatory compliance, and uses analytics to strengthen investigations. The position offers remote leadership for a hybrid workforce, opportunities to collaborate with regulators and providers, and a payroll with comprehensive #J-18808-Ljbffr Blue Cross and Blue Shield of North Carolina
$107.9k - $172.64k
...Description Blue Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on... ..., or program improvements as needed. Collaborate with leaders who manage vendor relationships that support business...SuggestedWork at officeLocal areaRemote workFlexible hours2 days per week- PACS Group, Inc. is seeking a Clinical Compliance Auditor I to perform routine audits of clinical documentation, regulatory compliance practices, and reimbursement processes in Skilled Nursing Facilities. The role ensures adherence to CMS and state regulations, supports...SuggestedRemote job
- ...care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded... ...billed DRG codes, and help identify overpayments. A brief coding/auditing assessment may be included as part of the interview process #J...SuggestedRemote work
- ...characteristic. Employment decisions are based on qualifications, merit, and business needs. Job Summary The Clinical Compliance Auditor I is responsible for conducting routine audits of clinical documentation, regulatory compliance practices, and reimbursement related processes...SuggestedWork at officeLocal areaRemote workFlexible hours
- ExlService Holdings, Inc. is seeking a Clinical Validation Auditor to review inpatient records and validate billed DRG codes. You will apply clinical judgment to ensure accuracy and fairness in claims coding while working remotely. Ideal candidates are licensed nurses...SuggestedRemote job
$120k - $150k
...Clinical Risk ManagerThe Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for reviewing... ...supports the success of every individual.At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel...TraineeshipLocal areaFlexible hoursShift work$120k - $150k
...Clinical Risk Manager The Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for... ...supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel...TraineeshipLocal areaFlexible hoursShift work- ...goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams... ...Develops and delivers educational content to clients related to audit findings. This is a remote position. Essential Duties and Responsibilities...Work at officeImmediate startRemote workShift work
- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative documentation to identify... ...or wasteful practices. The role involves site visits, desk audits, and collaboration with a team of auditors to document findings...Remote jobFull timeLocal area
$42.54 - $65.94 per hour
...experience, among other factors. Position Highlights Position: Clinical Risk Manager Location: Evanston, IL Full Time: 40 hours/week Hours... ...Collaborates with Performance Improvement team and Operational Leaders to identify key quality and patient safety trends. Actively...Hourly payFull timePart timeFor contractorsMonday to FridayFlexible hours- ...and Rehabilitation is seeking a Quality Assurance Nurse to lead clinical quality initiatives, monitor CMS measures, and coordinate with... ...patient outcomes. This role involves on-site oversight, regular POC audits, and ongoing participation in on-call rotations to ensure safe,...
$87.5k
...top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences... ..., Twitter and LinkedIn. Brief summary of purpose: The SIU Code Auditor will conduct coding audits of medical records provided by providers to check for...Local area- ...(Associate) within the Infrastructure Platforms (IP) Technology Audit team, you will play a key role in executing Infrastructure Platform... ...brands. Our history spans over 200 years and today we are a leader in investment banking, consumer and small business banking, commercial...Visa sponsorship
- ...care. The It Portfolio Manager leads an assigned portfolio of clinical, operational, and technology initiatives that support organizational... ...assigned portfolio. Partner with IT, clinical, and operational leaders to understand resource constraints, implementation dependencies...
- ...organization's governance and operational excellence!As a Senior Internal Audit Associate within the Asset & Wealth Management Operations... ...brands. Our history spans over 200 years and today we are a leader in investment banking, consumer and small business banking, commercial...Visa sponsorshipFlexible hours
- Abbott, a global healthcare leader, is seeking a Senior Auditor for the Global Compliance Audit team. The role involves conducting cross‑border sales and marketing audits, reporting findings, and advising senior leadership. Travel 60-70% is typical to support global audits...
- ...Health and Integrated Care Overview Are you in your Masters program for ABA? We offer competitive pay and supervision as an Assistant Clinical supervisor!! Our therapy team executes customized treatment plans that deliver real results and exceed patients' expectations. If...
$90k - $115k
Company DescriptionFORTUNE 500 FINANCIAL SERVICE COMPANYMUST HAVE EITHER BIG 4 OR FINANCIAL SERVICE EXPERIENCEJob DescriptionIT Audit ManagerDescription Internal Audit is responsible for validating that (1) the Firm's financial statements are fairly stated and (2) the Firm...- Virginia Commonwealth University Health seeks an accomplished leader to direct real estate transition, activation planning, and operational... ...for new and renovated facilities. You will coordinate clinical, regulatory, IT, and facilities teams to ensure safe patient care...
- ...agentic revolution in travel. Sabre is an AI-native technology leader, backed by one of the world’s largest travel data clouds. Built... ...to retail, distribute and fulfill travel worldwide. The Internal Audit and Enterprise Risk Management team performs operational audits,...WorldwideFlexible hours
$100.35k - $205k
...professional who likes solving complex federal tax issues? Do you have experience serving real estate owners and operators? Are you a leader who has a solid understanding of Subchapter K, partnership allocation methodologies, and Real Estate Investment Trust qualification...Work at officeLocal areaWorldwide2 days per week3 days per week- Sabre Corporation in Dallas, TX seeks a Staff IT Auditor to join its global Internal Audit team. You will evaluate IT general controls, system access, and risk across a dynamic tech environment. The role emphasizes collaboration, analytical rigor, and improving internal...
- Las Vegas-based MGM Resorts International is seeking an Internal Audit Staff - IT to strengthen our technology controls and risk management. You will perform IT compliance audits, operational reviews, and special projects across the enterprise, analyzing processes and identifying...
$102.6k - $171k
...superior value proposition Obtain insights by leveraging key opinion leaders Understand customers and optimize the value proposition Analyze... ...new product development and launch planning Partner with Clinical Affairs to propose research objectives for evidence generation...Work experience placementWork at office2 days per week3 days per week- ...driven Sr. Internal Auditor to join our collaborative internal audit team, not just to review processes, but to serve as a catalyst for... ..., this position is a recognizable launchpad for future leaders. Based on performance, our top auditors are frequently presented...Full timePart timeWork at officeFlexible hours
- ...looking for an Internal Auditor to join our high-performing Internal Audit team that is a strategic business partner to all ATI businesses.... ...and ATI processes. As a Staff Auditor you will take a thought-leader approach in being able to provide solutions based on data and...Full timeWork at office
$109.25k - $125.5k
...This individual will work as part of the U.S. FinTech Internal Audit function to provide independent, objective assurance of corporate... ...and provide timely statuses of assigned tasks to engagement team leader in a manner that is clear and concise ensuring high quality and...Full timeWork experience placementH1bRemote work- ...Analytics Paramount About Senior Internal Auditor, Risk and Analytics Role Type Full-time Requirements 5 years of experience in internal audit, external audit, risk management, data analytics, or a related field Robust knowledge of operational risk, internal controls, audit...Full time
$69k - $75.6k
...standards of administrative practice. The Internal Auditor will perform audits at all levels of difficulty requiring the use of independence... ...similar work. Responsibilities may include serving as a team leader on some assignments as well as reviewing the work of lower-level...Full timePart timeWork at officeRemote workMonday to FridayFlexible hours- ...highly motivated Senior Internal Auditor to join our Internal Audit team. This role is responsible for leading and executing risk-based... ...internal audit roles. The ideal candidate is a collaborative leader with strong analytical skills, project management experience, and...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to SIU Clinical & Audit Leader. Be the first to apply!
- director internal audit Brooklyn, NY
- audit associate Brooklyn, NY
- audit director Brooklyn, NY
- night audit manager Brooklyn, NY
- senior audit manager Brooklyn, NY
- kpmg audit associate Brooklyn, NY
- pwc audit associate Brooklyn, NY
- audit manager Brooklyn, NY
- internal audit associate Brooklyn, NY
- audit supervisor Brooklyn, NY

