California Licensed Program Integrity Specialist

Job Summary

A company is looking for a Program Integrity Specialist II in the Compliance Department.

Key Responsibilities

• Conducts investigations into alleged fraud, waste, and abuse
• Assists with the administration of Program Integrity activities
• Supports privacy-related compliance activities

Required Qualifications, Training, and Education

• Bachelor's degree in Healthcare Administration, Public Health Administration, Criminal Justice, Finance, or a related field
• Minimum of three years of relevant experience in program integrity, auditing, or compliance in healthcare
• Knowledge of HIPAA regulations and data privacy principles
• Experience with Microsoft Office, particularly Word and Excel
• Knowledge of Medi-Cal and Medicare Advantage programs and regulations