BR-Compliance Program Specialist

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  • 17-00128
  • Direct Placement
  • 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
COMPLIANCE PROGRAM SPECIALIST

DESCRIPTION
Under the direction of the Manager of Compliance Program Oversight, the Compliance Program Specialist is responsible for the coordination of general daily functions within the Compliance Program Oversight Unit. The Compliance Program Specialist provides support to the Compliance Program Oversight Unit to track, monitor, report, and trend activities related to planning, development, and operations of the Compliance Program.

  • Responsible for supporting the Compliance Program in the development, implementation, and monitoring of processes, special projects, program initiatives, process improvement and operations.
  • Work cooperatively with the Compliance Program Oversight Unit staff to develop, maintain, and update project activities to ensure effective and timely completion. Identify changes and/or concerns in project plans and communicate as appropriate to stakeholders.
  • Effectively communicate project expectations and assigned deliverables to stakeholders, including reminder and follow-up notices when project tasks or deliverables are due.
  • Provide support to maintain the Compliance Program Policies and Procedures, including interim and annual updates, as well as support the policy review process utilizing policy management software.
  • Provide support to maintain the Compliance Department work plan, including updates, tracking progress of scheduled activities, and regular status reports.
  • Effectively manage assigned projects and tasks. Monitor special projects and create performance reports.
  • Responsible for the intake, tracking, and monitoring of issues of non-compliance and department inquires to ensure timely completion and effective support to the business units within the organization. Escalates issues of non-compliance to management as appropriate.
  • Work collaboratively with the Compliance Specialist Privacy and Compliance Specialist FWA, to provide support and coverage for responsibilities related to the intake and processing of compliance issues reported.
  • Maintains files of issues of non-compliance, inquiries, and projects assigned to ensure thorough and complete documentation.
  • Supports the Compliance Training Program including but not limited to, scheduling, file maintenance, materials maintenance, training documentation, and assists in the development of programs and materials.
  • Assist with departmental office administration coordination, including word processing and other computerized applications, record management and general office management.
  • Prepare ad hoc reports, charts, and graphs as needed to support the Compliance Program.
  • Be familiar with Federal and State regulatory requirements and respond timely to resolve issues.
  • Perform any other duties as assigned to ensure Compliance Program operations are successful.
  • Ensure the privacy and security of PHI (Protected Health Information) as outlined in company’s policies and procedures relating to HIPAA compliance.

SKILLS & QUALIFICATIONS

  • High School diploma or equivalent required. Bachelor’s degree preferred.
  • Minimum of three (3) years of experience required in an office environment.
  • Extensive knowledge of MS Excel at an advanced level, with ability to create complex spreadsheets.
  • Experience with MS Visio at a proficient level.
  • Experience in generating reports and preparing charts and graphs.
  • Proficiency in other MS Office products (Word, PowerPoint, Outlook, Access).
  • Health care experience strongly preferred.
  • Knowledge of managed care industry operations, practices, and standards preferred.
  • Knowledge of compliance program practices and elements preferred.

COMPENSATION | POSITION CLASSIFICATION

  • Commensurate with Experience
  • Benefited | Full-Time | Non-Exempt


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