Compliance Specialist

US-CA-Commerce
Job ID
2017-5480
Category
Compliance / Risk Management

Overview

Responsible for executing Compliance Program priorities and strategies in alignment with overall organizational objectives and through effective partnerships with service-level management. Primary contact for the delivery of Compliance service-level engagement and training for a business unit or corporate functional group. Successful Specialists will act as a business consultant and change agent. Specialists continually assess and anticipate Compliance Program needs for the business unit and overall organization. The Specialist is a hands-on Compliance expert who formulates partnerships across departments to deliver value added service to management and employees that reflect the business objectives of the organization. The Specialist maintains an effective level of business literacy about the assigned business unit’s strategic objectives, requirements, and performance.

 

 

Responsibilities

  1. Remain visible and accessible to service-level business units, engaging employees on-site to ensure awareness of the Corporate Compliance Program.
  2. Develop and implement in collaboration with service level management corrective action plans to resolve detected non-compliance, including facilitating root cause analysis for repeated non-compliance and/or high risk conditions.
  3. Drive the understanding and interpreting of internal monitoring and compliance metrics at the service level, including directing actions to improve gaps in contractual and regulatory compliance.
  4. Remain abreast of service-level needs in order to guide management’s consistent application of Compliance Program elements at the service level.
  5. Responsible for execution of compliance functions at the site and service level, including reporting, analysis, education, and action planning.
  6. Assist with investigating allegations of non-compliance or regulatory violations, including those received from the anonymous or confidential hotline.
  7. Assist with the implementation of Compliance program communication and training plans, including collaborating with other corporate support teams and service-level business units.
  8. Provide guidance with interpreting regulations and health plan guidelines.
  9. Consult with Compliance Manager and/or Director in the most complex situations.
  10. Other duties as assigned

 

Qualifications

  1. Bachelor’s degree or equivalent work experience healthcare compliance related role.
  2. Certification in healthcare compliance
  3. 1-3 years of experience with internal monitoring, corrective action planning, performance improvement, and relevant Federal, State, and local healthcare compliance laws & regulations.
  4. Bilingual Spanish/English a plus.

 

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