Compliance Coordinator

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• Coordinate and perform ongoing processes supporting various Compliance initiatives such as provider and vendor exclusion screening, operational approvals and library maintenance as well as general support of other compliance technology platforms as required. Assist with developing compliance and regulatory materials and/or training tools as needing to educate internal departments on new technology supporting federal and state regulatory changes and initiatives.
• Assist compliance team in maintaining incoming health plan updates related to IPA compliance program and contractual requirements and disseminate key information to lead teams internally, as needed.Maintain internal documentation to ensure compliance and regulatory changes/updates are logged for record keeping.
• Maintain documentation and prepare materials for Compliance Committee and other internal workgroups as it pertains to the Compliance Department.
• Assist Compliance team in tracking areas of compliance and regulatory vulnerability while assisting in documenting updates for audit submissions.
• Coordinate and maintain master audit calendar for all health plan audits/CAPs/Readiness preparation.
• Work collaboratively with all departments to follow up on audit items and ensure accuracy of information provided and timely submission, as needed.
• Assist Compliance team to track regulatory deadlines and submit various reports as it relates to other contractual requirements.
• Assist with tracking compliance of required policy changes when modifications are needed according to a regulatory update, health plan specific department audits, CAPs or Readiness. Assist with tracking updates to HIPAA policies and procedures for the Compliance Department.

Qualifications

• High School Diploma required; Bachelor’s Degree preferred.
• Minimum of 1- 1 ½ years related experience in government programs, preferably with direct experience dealing with managed care operations and/or interpreting and applying complex Medicaid and Medicare rules and policies in a healthcare administration setting. Strong computer skills, data entry, Word, Excel, PowerPoint and office equipment.
• Working knowledge of basic health care systems and/or IPA operations. Ability to understand and present information effectively and respond accurately to questions from business departments, outside agencies and vendors, and Management.
• Strong reasoning, problem-solving, project management and organization skills, with a high level of attention to detail.
• Excellent verbal/written communication, relationship-building and time management skills. Excellent technical writing skills with the ability to draft policies in a clear, concise manner.
• Ability to adapt to changing priorities and to manage various projects simultaneously. Work independently on assigned projects.
• Working knowledge of DHCS, DMHC and CMS requirements is required. Speak, read, and write English proficiently.

Environmental Job Requirements and Working Conditions

• This is a primarily remote position where the expectation is to work at home. You will be required to be onsite as needed (~few times per month). The home office is located at 600 City Parkway West 10th Floor, Orange, CA 92868.
• The national target pay for this role is $23 to $28 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.