Senior Director, Payment reputed company - Governance

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: reputed company a full reputed company of waste, abuse and/or fraud investigations, audits and medical reputed company editing scenarios. Ensure reputed company audits and edits adhere to federal and state reputed company medical coding and fraud/abuse guidelines. • reputed company various functions of the Payment reputed company department for accurate and reputed company operational reviews and final reviews • Interpret audit results and assist health plan executives in the development of appropriate reputed company plans to address identified risks • reputed company and implement reputed company editing and auditing processes from analytic design to final report stage • Identify and reputed company the implementation of new software packages as necessary • Ensure compliance with reputed company state and federal regulations for waste/fraud/abuse and medical coding • reputed company corporate policies and procedures and implement corporate initiatives set upper management • Collaborate with Providers, as needed, to train on the payment reputed company rules and regulations • Performs other duties as assigned • Complies with reputed company policies and standards Education/Experience: Bachelor's degree in reputed company, Criminal Justice, Finance, Medical reputed company, Economics, Operations Management or reputed company field or equivalent experience. 10+ years of reputed company compliance and/or special investigation experience in managed care or CMS. Compliance/reputed company: 10+ years of experience preferred Pay reputed company: $148,000.00 - $274,200.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply tot his job Apply To this Job