Sutter Health System Office

  • Sacramento, CA, USA
Nov 29, 2021
Sutter Health System Office Remote * (Mather, CA 95655, USA)
This position is eligible to work from home in the following states: Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Missouri, Montana, Nevada, North Carolina, Oregon, South Carolina, Tennessee, Texas, and Utah Responsible for supporting the technical operations of the Managed Care Administration team and EPIC Tapestry application by monitoring, analyzing, and recommending improvements. The team works on complex projects and problems that require in-depth evaluation, understanding of the business processes and innovative solutions. This position will include monitoring, basic analysis, and distribution of incoming requests, and periodic auditing of completed projects and contract builds (including annual internal process audits). In addition, this position will include analysis of patient benefit activity and various assignments that do not conflict with the audit responsibility. This individual will develop strong working relationships with Client Services,...
Nov 11, 2021
Sutter Health System Office Remote * (Sacramento, CA, USA)
The Compliance Program Manager will assist and support affiliate Compliance Officers with oversight and monitoring of the corporate compliance functions for their respective Sutter Health regional organization. Working under the direction of the Regional Compliance Officer, the primary focus will be to: • Assist with coordination, implementation and evaluation of the Compliance Plan; • Partner with management to conduct compliance risk assessments, to develop compliance policies and procedures • Assist in the conduct of internal investigations; • Develop and coordinate related education and training activities to ensure they promote an institutional culture favorable to compliance and; • Assist with monitoring and auditing activities under the compliance plan. Qualifications Education, Certification, and Licensure • A Bachelor's degree preferably in a health related field required; Masters Degree or Juris Doctor degree preferred. • Certified in Healthcare Compliance...
Nov 11, 2021
Sutter Health System Office Remote * (Sacramento, CA, USA)
This position is eligible to work from home in the following states: Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Missouri, Montana, Nevada, North Carolina, Oregon, South Carolina, Tennessee, Texas, and Utah Under general direction from the Quality Assurance Manager, performs quality assurance monitoring reviews of clinical quality coding staff work activities to ensure compliance with the elements of the quality program such as Hierarchical Condition Category (HCC) / Medicare Advantage Program as well as coding guidelines and policies. Analyzes findings from quality monitoring reviews of coding staff, and other relevant coding data, in order to provide feedback and support for training and clinical documentation improvement efforts. Provides monitoring results to Clinical Quality Coding Lead as well as Clinical Quality Coding Manager and Clinical Quality Coding Educators with shared recommendations for course-correction and education as needed....
Nov 03, 2021
Sutter Health System Office Remote * (Roseville, CA, USA)
The person hired for this role has the option to work from home and must come on site as needed for meetings, etc. The hub for this role is Roseville. The Compliance Officer administers the Sutter Health Ethics and Compliance Program at [Affiliate] by implementing systems and processes designed to ensure compliance with applicable laws, regulations and standards (e.g., Department of Health and Human Services Departments, including the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG)). The Compliance Officer assists senior management and governance boards in carrying out their respective roles and responsibilities by providing compliance monitoring, reporting, training and advice. Qualifications Education: A Bachelor's degree or clinical degree in health care related field with substantial experience in healthcare compliance will be considered. Master's degree preferred. (e.g., MPH, MBA, MHA, JD, MD, etc.). Certification:...