Compliance Specialist
Chinese Community Health Plan - San Francisco, CA

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Established in 1986, Chinese Community Health Plan (CCHP) is the health plan subsidiary of Chinese Hospital. Our mission is to provide culturally competent and linguistically appropriate health care at an affordable price to community businesses and individuals who are generally not served by the broader health insurance market.

JOB SUMMARY
The Compliance Specialist supports the efforts of the Director of Regulatory Affairs and Corporate Compliance Officer to improve CCHP’s public presence and to provide excellent service to our existing and potential members, fellow employees, and business partners. With strong organizational skills, the Compliance Specialist assists the director of regulatory affairs and corporate compliance officer in achieving the goals and objectives; identifies and resolves a variety of issues related to regulatory issues; maintains basic commercial regulatory files; develops and facilitates marketing materials; and prepares and submits Medicare/commercial marketing materials to federal and state regulators. .

JOB DUTIES
Assists with regulatory filings into the Department of Managed Health Care (DMHC) and Centers for Medicare and Medicaid Services (CMS) protocols. Assist the director of regulatory affairs and corporate compliance officer to monitor the day-to-day compliance activities.Conduct the compliance risk assessment process and direct the compliance-related assessment tools and testing programs and mitigation, monitoring, auditing, and post-cycle review activities deemed necessary based on risk assessment results affecting DMHC policies. Assist the director of regulatory affairs and corporate compliance officer with responding to compliance hotline reports, department calls, or other contacts. Assist with strategizing potential solutions and their implementation, including but not limited to compliance review spot-checks, training sessions, or policy revisions. Perform ongoing compliance reviews to detect or confirm compliance violations.

QUALIFICATIONS
Bachelors degree or equivalent; Business Administration, Health Care or related field preferred
Two years prior experience in a health care environment.


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About this company
CCHP is committed to serving our community and is devoted to delivering the highest quality health plan to the people and organizations we...