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Live In Remote Datastage Developer Jobs in California

Noor Staffing Group

SDET, Remote opportunity

Irvine, CA · On-site +1

$130K - $145K/yr

Senior SDET Location: Hybrid if local to Irvine, CA. 100% remote if you live more than 30 miles from the office. Our client is one of the leading mortgage technology companies in the country ...

psudo

Remote : OK Job Role: As a software developer, you'll be the brain behind crafting, developing, testing, going live and maintaining the system. You are passionate in understanding the business ...

Joby Aviation

Senior Software Engineer

Santa Cruz, CA · Remote

$193K/yr

... in remote and constrained environments * Support Kubernetes-based deployments in edge environments ... Mentor engineers and champion best practices in system software development and operational ...

The Aerospace Corporation

Optical Engineer

El Segundo, CA · On-site +1

$137K - $177K/yr

At the Mission Payloads Division (MPD), we are pioneers in remote sensing systems that guide our ... We are seeking to hire a laser communications engineer (Engineering Specialist) to join the Optical ...

Runware

Developer Relations Engineer

San Francisco, CA · On-site +1

Your focus is community presence, live demos, education, and real-world interaction . * Location ... Benefits We're a remote-first collective, meeting in person twice a year to plan, brainstorm ...

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Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska

Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska

Molina Healthcare

Long Beach, CA • On-site, Remote

$27.59 - $56.63/hr

Full-time

Posted 26 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

143rd of 277 rated insurance

Job description


JOB DESCRIPTION
This position will offer remote work flexibility, but the selected candidate must reside in Nebraska.
Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with NCQA standards is vital to success in this role. The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Hours are Monday - Friday, 8AM - 5PM in your time zone.
Job Summary
Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Performs audits in care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
• Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
• Assesses clinical staff regarding appropriate clinical decision-making.
• Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
• Ensures auditing approaches follow a Molina standard in approach and tool use.
• Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
• Adheres to departmental standards, policies and protocols.
• Maintains detailed records of auditing results.
• Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
• Meets minimum production standards related to clinical auditing.
• May conduct staff trainings as needed. • Communicates with quality and/or healthcare services leadership regarding issues identified and works collaboratively to subsequently resolve/correct.
Required Qualifications
• At least 2 years health care experience, with at least 1 year experience in care management, and/or managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and restricted in state of practice.
• Strong attention to detail and organizational skills.
• Strong analytical and problem-solving skills.
• Ability to work in a cross-functional, professional environment.
• Ability to work on a team and independently.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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