2 jobs found in Imperial

About us Community Health Plan of Imperial Valley (CHPIV) is committed to improving the health and well-being of our community by offering accessible, high-quality, and culturally sensitive healthcare services. We are a local health plan dedicated to making a positive impact through education, outreach, and innovative care. The Compliance Auditor plays a critical role in advancing the mission of Community Health Plan of Imperial Valley (CHPIV) by ensuring that administrative/non-clinical functions performed by delegated entities are in full compliance with regulatory, contractual, and clinical standards. About the role Our new Compliance Auditor will do the following: Evaluateprocess compliance and operational workflows for internal and delegated functions. Identify systemic issues and contributeto corrective action planning. Monitorregulatory metrics and reporting to committees. Conduct audits of non-clinical delegated functions including claims, encounters, credentialing,...

Community Health Plan of Imperial Valley is seeking a Compliance Auditor to ensure non-clinical delegated functions comply with regulatory, contractual, and clinical standards. You will evaluate workflows, identify issues, monitor metrics, and conduct audits across claims, credentialing, and language services, while collaborating with internal teams to maintain ongoing compliance. The role requires a Bachelor's degree in a related field and 3–4 years in compliance or auditing, with familiarity #J-18808-Ljbffr