Source Job

Supports administration of ISACA’s certificate and certification exams. Assists with triaging and resolving customer issues related to exam delivery. Collaborates with cybersecurity team to support the investigation of potential exam fraud incidents.

ISACA® champions the global workforce advancing trust in technology.

Document and communicate audit findings to management and recommend corrective actions to improve compliance. Provide staff education on privacy standards, compliance policies, and regulatory requirements. Review, investigate, and respond to facility inspections and/or deficiencies issued by regulatory agencies.

SimonMed Imaging is the fastest growing outpatient radiology practice in the Nation and is committed to excellence and improving patient care.

• Responsible for conducting routine internal audits and providing follow-up on deficiencies.
• Provide leadership, guidance, and oversight to a small team.
• Serve as a super user for Policy Manager and partner with the CommonSpirit Compliance team.

Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers.

• Complete monthly utilization management and appeals performance and process audits.
• Present audit results to leadership to address issues.
• Assist management in identifying, evaluating, and mitigating risks.

Judi Health provides a comprehensive suite of solutions for employers and health plans. They offer full-service health benefit management solutions and consolidate all claim administration-related workflows in one scalable, secure platform.

• Perform auditing of claims, ensuring processing, payment, and financial accuracy.
• Complete reporting of audits finalized with decision methodology for procedural and monetary errors.
• Communicate corrections and adjustments to Examiners as identified on pre-payment audits.

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their bills.

The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.

Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.

Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.

• Protect users by investigating potential fraud and policy violations.
• Verify new employers via phone and email to ensure a high-quality experience.
• Review job advertisements to ensure compliance with guidelines.

ZipRecruiter is a leading online employment marketplace, using AI to connect businesses and job seekers. They have the #1 rated job search app and offer innovative mobile, web, and email services to actively connect people to their next great opportunity.

• Be the primary point of contact for all providers.
• Provide professional, accurate and timely responses to all provider inquiries.
• Maintain a current knowledge of all contract requirements and objectives.

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans.

Conduct investigative assignments primarily by phone and online research. Plan investigative strategies by reviewing case documentation and client instructions. Write detailed, accurate, and unbiased reports that clearly document findings and conclusions.

CoventBridge Group is a global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, and Counter-Fraud Programs.

The Quality Reporting Specialist plays a critical role ensuring practice and ACO success in Medicare Advantage and commercial contracts, with a focus on HEDIS quality measures. Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans. Submit documentation to health plans and employ the optimal methods in each practice.

Aledade exists to empower the most transformational part of our health care landscape - independent primary care.

The Compliance Manager manages compliance programs related to laws and regulations. Ensure the effectiveness of compliance frameworks. Support the development of policies, procedures, and training programs.

FUJIFILM Holdings America Corporation is redefining innovation across industries like healthcare, photography, semiconductors, and data storage.

Plan and schedule remote security assessments for new and existing third-party relationships/engagements. Communicate Experian's third party risk management/security due diligence requirements to internal and external stakeholders. Identify information security deficiencies or risks at third parties and communicate with all stakeholders to obtain action plans, due dates, and documentation to evidence remediation of identified security risks/gaps.

Experian is a global data and technology company, powering opportunities for people and businesses around the world.

• Evaluate and conclude claims identified by SIU Investigators.
• Investigate unusual, questionable, or suspicious claims or underwriting activity.
• Serve as the adjuster of record on transferred claims.

USAA's mission is to empower its members to achieve financial security through highly competitive products, exceptional service and trusted advice.

• Maintain up-to-date knowledge of program policies and procedures, integrating changes promptly into QA and M&E activities
• Collect, analyze, and track service delivery data to monitor compliance, highlight trends, and identify improvement opportunities
• Collaborate with program teams to implement participant feedback tools, ensuring child-centered, culturally responsive, and strengths-based approaches

Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.

• Own PHIL’s enterprise privacy program, serving as the company’s Privacy Officer and primary point of accountability
• Lead compliance with HIPAA, state privacy regulations, and client-specific contractual requirements
• Develop and maintain privacy policies, procedures, training, and documentation

PHIL, founded in 2015, is a Series D health-tech startup building a platform that interfaces between doctors, pharmacies, and patients to streamline the process of patients receiving prescriptions. The team at PHIL is a group of like-minded individuals from varying backgrounds, passionate about creating a new and innovative healthcare platform focused on patient experience and overall human wellbeing.

• Ensure adherence to payer requirements and internal compliance standards.
• Support audit readiness, reduce denials, and improve claim resolution.
• Maintain payer setup and readiness including fee schedules.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients.

• Review and audit prescriptions and delivery slips for completion and accuracy.
• Collaborate with clinicians in specialty clinics to ensure seamless medication management and adherence.
• Educate patients on how pharmacy services enhance care and improve outcomes.

Shields Health Solutions is a fast-growing leader in specialty pharmacy management services, dedicated to making a real difference in patients’ lives.

• Proactively grow the specialty pharmacy patient population by identifying eligible patients.
• Complete patient benefits investigations using approved tools and systems.
• Collaborate with team members to provide integrated, quality patient care and contribute to process improvement initiatives.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment.

• Conduct thorough audits of medical records and coding practices.
• Develop and deliver educational programs on coding best practices.
• Collaborate with billing, clinical, and revenue cycle teams.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.