Job Description
Investigative Responsibilities:
- Conduct investigations into fraud allegations.
- Assist in administering Program Integrity activities.
- Support privacy-related compliance activities.
Compliance & Regulatory Focus:
- Interpret requirements and mitigate risk.
- Maintain knowledge of HIPAA regulations.
- Ensure data privacy and security.
Required Skills & Experience:
- Experience in a managed care or healthcare environment.
- Proficient in Microsoft Office, especially Word and Excel.
- Knowledgeable of Medi-Cal and Medicare Advantage programs.
About Central California Alliance for Health
Central California Alliance for Health is an award-winning regional Medi-Cal managed care plan providing health insurance to residents in multiple counties.