Analyst I – Compliance Program

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  • 18-00232
  • Full Time/Contract
  • Compliance
  • Rancho Cucamonga, CA
Job Description
CLIENT COMPANY OVERVIEW
Our Client is a not-for-profit, rapidly growing Medi-Cal and Medicare health plan serving over 1,138,447 residents of the Riverside and San Bernardino counties. Our client maintains a Positive Team Culture as demonstrated by being voted by Los Angeles News Group readers as "Favorite Overall Company to Work For, "Favorite Training Program and "Favorite Workplace Culture in their 2014 Winning Workplaces survey.

JOB TITLE
Analyst I Compliance Program

DESCRIPTION
Under the direction of the Manager of Compliance Administration, the Analyst I Compliance Program has general knowledge and performs key Compliance Program activities of moderate difficulty. Team Members in this position are responsible for assisting in the development and implementation of the Compliance Program through operational processes, special projects, and the seven (7) elements of an effective compliance program.

  • Lead and support Compliance Program objectives and projects to ensure program effectiveness and maintain compliance with regulatory and contractual requirements.
  • Provide strategic project management support to develop and facilitate cross-functional work groups to accomplish projects. Provide creative, results driven, and self-motivated solutions to timely execute projects.
  • Monitor project development and prioritizes needs; define project scopes, goals and deliverables. Pro-actively manage projects to successful conclusion and report status utilizing standard tools including project milestones, project plans and reports.
  • Maintain internal work plan by identifying areas of non-compliance and developing recommendations to ensure program effectiveness.
  • Triage compliance issues and inquiries from departments and units, understand the underlying intent of the questions and perform necessary research and analysis to provide accurate responses and recommendations.
  • Proactively identify areas of improvement for the Compliance Department and participate in the development of performance improvement initiatives.
  • Support compliance program effectiveness through:
    1. The development, maintenance, and revision of policies and procedures for the general operation of the Compliance Program and related activities.
    2. Develop/contribute to comprehensive reports to the Governing Board, partnering with peers to ensure all necessary information is communicated to the Governing Board allowing the Board to exercise reasonable oversight of the Compliance Program.
    3. Organize and support Compliance Committee meetings which includes ensuring relevant and necessary information is presented to allow the Committee to support and advise the Compliance Program.
    4. Support the development and delivery of Compliance, FWA, and Privacy Training to ensure the staff is knowledgeable of and complies with applicable Federal, State, and industry standards.
    5. Support the development of the Compliance Program Communication Plan and awareness campaigns.
    6. Participates in and conducts investigations concerning compliance issues
    7. Monitor program/department dashboards, corrective action plans, and other monitoring activities to ensure risks are mitigated.
  • Develop, lead, facilitate, and participate in relevant committees and work groups; create presentations, prepare reports, data, or other materials for presenting and training.
  • Prepare for and participate in audits; draft audit responses and reports as needed
  • Any other duties directed by the Manager of Compliance Administration to ensure Health Plan operations are successful.

SKILLS & QUALIFICATIONS

  • Bachelor’s degree from an accredited institution required.
  • 1-3 years of experience in a business or healthcare environment.
  • Certified in Healthcare Compliance (CHC) preferred but not required.
  • Associate or Project Management Professional certification preferred but not required
  • Knowledge of the elements of an effective compliance program and broad knowledge of managed care industry practices and standards including both Federal, State regulations and accreditation standards preferred.
  • Knowledge of basic project management principles preferred.
  • Effective communication skills; verbal and written.
  • Ability to establish and maintain effective working relationships with others.
  • Ability to manage multiple projects with competing deadlines and changing priorities.
  • Ability to apply knowledge and address situations appropriately without extensive guidance.
  • Ability to work independently and collaboratively within a team environment.
  • Willingness to provide department support on a wide range of operational activities.
  • Resourcefulness and independent in solving problems; strong attention to detail. Microsoft Office programs including, but not limited to: Word; Excel; Power Point; Outlook; Access

COMPENSATION | POSITION CLASSIFICATION

  • Commensurate with Experience
  • Full-Time

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