961 health plan compliance auditor jobs found

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health’s internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities. Responsibilities Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal, state, and...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health's internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities. Responsibilities: • Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal,...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health's internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities. Responsibilities: Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal,...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health's internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities. Responsibilities: Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal, state,...

CVS Health is seeking an Associate, Delegation Compliance to support Oak Street Health's compliance activities. You will partner with operational leadership to implement quality improvement, coordinate audits, and ensure adherence to CMS, NCQA, and Medicare Part C requirements. This role requires a Bachelor's degree in Healthcare Administration or related field, 1–2 years of compliance experience, and strong analytical, communication, and problem-solving skills. US work authorization is required. #J-18808-Ljbffr

Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: 2026-09-01Inland Empire Health Plan (IEHP) seeks a Compliance Auditor II to conduct comprehensive audits across the Plan and delegates, ensuring adherence to Federal, State, and contract requirements. The role identifies risks, drafts findings and actionable recommendations, and evaluates operations for compliance and effectiveness.Responsibilities include developing audit tools, validating CAPs, and performing routine monitoring.#J-18808-Ljbffr

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment. The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation. #J-18808-Ljbffr

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment. The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation. #J-18808-Ljbffr

Pharmacy Compliance Auditor – 340B Program Join our team as a Pharmacy Compliance Auditor – 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you'll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we'd love to hear from you! Location: Norwood, OH Work Hours: Full Time, 80 hours biweekly; Day shift No...

Compliance Auditor The Compliance Auditor will foster an environment that enhances and promotes compliance and adherence to all relevant federal, state, and local laws, rules, and regulations applicable to PACE, Part D, LHCSA, and Article 28 requirements, etc., through audits. The Compliance Auditor is responsible for performing internal and external auditing functions for the Compliance Department of CenterLight. The Compliance Auditor utilizes regulatory expertise to conduct effective risk assessments and assist in preparing an annual audit plan. Responsibilities include: Develop comprehensive audit programs to address risks and evaluate compliance with governmental or other regulatory requirements. Assess control weaknesses by conducting independent audits according to the annual audit plan and develop appropriate documentation to support audit work performed. Use information effectively to support a viable position. Make self-available to help others solve...

Inpatient Coding Auditor Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role:...

Inpatient Coding Auditor Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role:...

Operations Support Compliance Auditor Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish strong credibility with the Monro Field Teammates and Field Leadership. Maintaining a positive and constructive attitude is critical as this role sits at the crossroads between the Store Support Center and Field Management. Compensation: The salary range for this role is $68,000 - $85,000. This role is eligible for additional compensation and incentives. Pay will be determined based on experience level. Essential Functions: Participates in the following areas of focus, including but not limited to Monro Forward initiatives, DM onboarding, inventory subject matter expert, inventory analysis, safety compliance, building and equipment maintenance, and...

Inpatient Coding Auditor Hourly Wage Estimate: $34.59 - $51.89 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As an Inpatient Coding Auditor with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for...

Inpatient Medical Coding Auditor As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient records. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review inpatient records for diagnostic and procedural coding accuracy and compliance Review physician documentation to verify diagnoses and procedures Identify accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, Solventum (3M), in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company's clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up to date with industry standards Conduct other reviews, audits and other tasks at the...

What We Offer Excellent health benefits plan, which includes medical, vision and dental options 401(k) with company match Company profit sharing plan Generous paid time-off and paid holidays Paid parental leave 2 free on‑site fitness rooms Employee Assistance Program Employee Resource Groups Personal and professional development program Job Summary The Junior Franchise Compliance Auditor I performs audits of franchise owners from start to finish, from selection of Franchises audited to issuance of audit reports and collection of audit findings. In addition to performing audits of franchises, this position is responsible for reviewing other businesses owned by SERVPRO® franchise owners and personal accounts of SERVPRO® owners. The audits are performed primarily in order to determine if franchises are properly reporting and paying royalties. Auditors will provide recommendations to franchises regarding office procedures and bookkeeping. You will Review of Franchises to...

## Compliance AuditorApplylocations: MHC Nashville, TNtime type: Full timeposted on: Posted Todayjob requisition id: JR102201Ranked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee.Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis.If you are interested in joining a team that is caring, collaborative, innovative...

## Senior Lead Compliance Auditor (Hybrid) - Internal AuditApplyremote type: Hybridlocations: Washington University Medical Campustime type: Full timeposted on: Posted Todayjob requisition id: JR95595# **Scheduled Hours**37.5# **Position Summary**The purpose of the Washington University Compliance Program is to minimize instances of noncompliance with external laws and regulations, as well as related internal policies and procedures. Although university administration, faculty, and staff are responsible for various aspects of compliance as part of their roles, the Senior Lead Compliance Auditor plays a significant part in the overall compliance program. The Senior Lead Compliance Auditor works in the Office of University Compliance and Internal Audit. This position is responsible for evaluating the University’s state of compliance with federal research and other federal regulations, as well as related University policies. Such compliance is crucial to the success and...

Operations Support Compliance Auditor Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish strong credibility with the Monro Field Teammates and Field Leadership. Maintaining a positive and constructive attitude is critical as this role sits at the crossroads between the Store Support Center and Field Management. Compensation: The salary range for this role is $68,000 - $85,000. This role is eligible for additional compensation and incentives. Pay will be determined based on experience level. Essential Functions: Participates in the following areas of focus, including but not limited to Monro Forward initiatives, DM onboarding, inventory subject matter expert, inventory analysis, safety compliance, building and equipment maintenance, and a...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Operations Support Compliance Auditor Reporting to the Director of Operations Support, this individual will evaluate, inspect, audit, and determine the effectiveness of compliance and store operational tasks. This individual will visit store locations daily and perform regularly scheduled audits. They must effectively establish strong credibility with the Monro Field Teammates and Field Leadership. Maintaining a positive and constructive attitude is critical as this role sits at the crossroads between the Store Support Center and Field Management. Compensation: The salary range for this role is $68,000 - $85,000. This role is eligible for additional compensation and incentives. Pay will be determined based on experience level. Essential Functions: Participates in the following areas of focus, including but not limited to Monro Forward initiatives, DM onboarding, inventory subject matter expert, inventory analysis, safety compliance, building and equipment maintenance, and...

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