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Senior Regulatory Implementation and Assurance Analyst
Pennsylvania or Maryland or Washington or North Carolina or Louisiana or Kentucky or Kansas or Indiana or Illinois or Georgia or Iowa or Florida or Colorado or California or Delaware or Connecticut or Arkansas or Arizona or Alabama or Alaska or Nevada or Vermont or Tennessee or Idaho or Oklahoma or Hawaii or Mississippi or Utah or New Hampshire or New Mexico or Wyoming or North Dakota or South Dakota or Rhode Island or West Virginia or Missouri or Texas or District of Columbia or Ohio or New Jersey or Oregon or South Carolina or Virginia or Massachusetts or Nebraska or Minnesota or Michigan or Wisconsin or New York or Maine
$79k-$127k/yr HybridFull Time
5+ YOE5+ years interacting with regulators/auditors, bachelor’s degree or equivalent experience, knowledge of regulatory frameworks (HIPAA, NIST, PCI, CMS, NCQA), strong communication, analytics, and project leadership skills.
21h
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Managed Care Coordinator II
Hopewell or New Jersey or New York or Pennsylvania or Connecticut or Delaware
$50k-$67k/yr RemoteFull Time
3+ YOEHigh school diploma/GED, 3-5 years customer service experience, knowledge of medical terminology, NCQA/CMS standards, ability to make sound decisions and strong communication skills.
1mo
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Quality Auditor II
Hopewell or New Jersey or New York or Pennsylvania or Connecticut or Delaware
$79k-$106k/yr RemoteFull Time
3+ YOEConduct clinical file audits for regulatory compliance (NCQA, URAC, CMS); requires 3+ years clinical experience and active unrestricted NJ clinical license; RHIT/CPC/CCS-P required for medical policy coding roles; bachelor's preferred.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Microsoft SharePoint, Care Planner Web, UCSW, Appeal Pro, Care Radius, Membership, Benefits, Business Objects, CMS websites, Milliman Care Guidelines (MCG-IRR)