Ensures compliance and adherence to regulatory requirements by monitoring internal policies and procedures and state and federal regulations and advising management on needed actions.
ESSENTIAL JOB RESULTS:
Ensures compliance with established internal control procedures by examining records, reports, operating practices, and documentation and providing information to the Director for approval.
Ensures compliance with state and federal agencies by studying existing and new legislation; auditing for adherence to requirements and participating in cross-functional teams to advise management on needed actions.
Ensures compliance by performing standardized audits and recommending new policies and procedures.
Provides guidance and information by interpreting policies and procedures: answering questions and requests, and upon Director?s approval forwarding to functional key contacts.
Maintains customer confidence and protects operations by keeping information confidential.
Prepares reports by collecting, analyzing, and summarizing information and trends.
Satisfies training needs by providing end-user training.
Maintains compliance database by entering and backing up data.
Maintains company reputation by complying with regulatory requirements in collaboration with the Compliance Department.
Provides support to the Senior Compliance Specialists for completion of specific projects.
Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
Contributes to team effort by accomplishing related results as needed.
Bachelor's Degree, or equivalent experience required.
Two years of experience in managed care.
Demonstrated understanding of HIPAA Privacy.
Ability to work effectively and participate in a team environment.
Ability to handle and prioritize multiple tasks simultaneously.
Proficient in MS Word.
CONDITIONS OF WORK:
Office Hours: Monday-Friday, 8am to 5pm.
Extended work hours and travel as needed.
SCAN Health Plan - 22 months ago
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