2 jobs found in Imperial

Job Description Job Description 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 Clinical Compliance Auditor plays a critical role in advancing the mission of Community Health Plan of Imperial Valley (CHPIV) by ensuring that clinical functions performed by delegated entities are in full compliance with regulatory, contractual, and clinical standards.  This position directly supports CHPIV’s enterprise compliance framework by enforcing accountability with contracted partners, promoting member safety and rights, and contributing to audit preparedness for state and federal agencies. About the role Our new Clinical Compliance Auditor will do the following:   Identify care delivery breakdowns and...

Job Description Job Description 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: Evaluate process compliance and operational workflows for internal and delegated functions. Identify systemic issues and contribute to corrective action planning. Monitor regulatory metrics and reporting to committees. Conduct audits of non-clinical delegated functions...