Regulatory Affairs & Compliance Specialist
San Francisco Health Plan - San Francisco, CA

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POSITION TITLE: Regulatory Affairs and Compliance Specialist

DEPARTMENT: Regulatory Affairs and Compliance

FLSA STATUS: Non-Exempt

REPORTS TO: Officer, Regulatory Affairs and Compliance

SUPERVISES: N/A

EVALUATION DATE: 10/2012

Under limited supervision, serves as administrative liaison between Officer, Regulatory Affairs and Compliance, direct reports and others within and outside the organization by providing advanced, highly responsible administrative support. Activities range from routine to complex, requiring excellent judgment and decision-making abilities. Requires initiative to determine proper approach or action to take in non-routine situations. Position will grow to have extensive knowledge of State health care programs and requirements, as well as substantial development in the areas of health care compliance, regulations and new health care reform initiatives at the local, as well as statewide levels (e.g. Medi-Cal expansions and children’s health programs).

This individual must be extremely professional, demonstrate high standards integrity, confidentiality, enjoy interacting with people at all levels, thrive in a fast-paced environment, and work with minimal supervision. Professional writing and communication skills are necessary for this position. Strong organizational skills, attention to detail and accuracy, the ability to meet deadlines are essential as are the abilities to multi-task and to maintain strict confidentiality while managing activities of the Officer, Regulatory Affairs and Compliance and department management team members. In addition, this individual assists the management team in reporting, coordinates staff for events and meetings, and takes the lead role on smaller projects as assigned.

ESSENTIAL DUTIES & RESPONSIBILITIES

Administrative Support to Officer, Regulatory Affairs and Compliance

Scheduling, phone support, meeting coordination, copying, meeting agenda preparation, meeting minutes coordination, etc.

Ad Hoc assistance to all department managers on miscellaneous administrative needs, e.g., copy, special meeting requests, etc.

Assisting in department recruitment effort, e.g., resume inventory, coordination with HR, scheduling, candidate tracking, gathering interview results, etc.

Other administrative tasks as assigned

Serves as administrative liaison between Officer, Regulatory Affairs and Compliance, direct reports and others within and outside the organization

Coordinates the activities of the Compliance and Policy Committee

Maintenance of the Compliance and Policy Committee’s share point site

Maintains, and reports on, the Compliance Program

Oversees and conducts designated internal audits

Coordinates audits by governmental agencies, as assigned

Trains staff on aspects of new legislation, contracts, compliance, HIPAA and other regulations

Serves as one of the liaisons to state agencies

Assists with the drafting, coordination and oversight of state filings

Assists with analysis and coordination of implementation of new regulations and legislation

Submit routine regulatory reports to State agencies. Coordinate with internal staff and external delegated medical contacts to ensure external deadline dates are met.

Ensures smooth functioning of assigned area of responsibility

Coordinates activities between departments as relevant to the Compliance and Regulatory Affairs department.

Coordinates administrative workflow of the department, and recommends new processes as needed

Appropriately refers substantive questions / key business issues to others and follows up to ensure resolution on behalf of manager

Assesses problems and develops solutions following general policies and procedures.

Performs special assignments for manager, which requires researching and collecting information needed to complete projects or reports; locating, analyzing and summarizing data to identify variances and provide recommendations; and producing reports requiring specialized content knowledge, which may be the basis of significant decisions

Policies and Procedures review, coordination, and database management.

Work with interdepartmental staff to ensure policies and procedures are reviewed and are up-to-date.

Department team building event planning and other initiatives to enhance communication

No supervisory responsibilities

INDIVIDUAL CONTRIBUTOR EXPECTATIONS

Takes the necessary steps to ensure he/she understands the SFHP mission and its overarching business goals and objectives.

Acts with integrity, honesty and fairness, remaining mindful of the duty of trust SFHP has to it employees, and to its providers, employers and members.

Accepts and adapts to changes in SFHP policy, practice, procedures quickly and positively and proactively supports his/her colleagues in adapting to changes in the workplace.

Contributes actively and effectively to team discussions, sharing his/her knowledge and expertise willingly and collaboratively.

Takes steps to ensure he/she understands departmental performance competencies metrics. Strives daily to ensure his/her individual performance meets or exceed the performance competencies and metrics. Offers assistance to other members of the team as appropriate in order to help the team meet its overall metrics goals.

Models professional behavior/conduct that remains in concert with the SFHP culture and business values. Leads by example whether in group or individual meetings.

CORE COMPETENCIES / KNOWLEDGE & SKILL REQUIREMENTS

Experience in coordinating and providing support to large complex projects

Excellent oral and written communication skills required.

Excellent attention to detail and organizing abilities.

Excellent logic, planning and problem-solving skills.

Strong knowledge and application of English grammar including composition, editing and proofreading skills.

Strong time management and project management skills and multi-tasking abilities.

Advanced level proficiency with MS Office applications (Word, Excel, PowerPoint, Access) with expertise with word processing, spreadsheets, graphics and presentation software including the ability to create tables; merge documents; and develop graphics and PowerPoint presentations from notes.

Familiar with a variety of general office concepts, practices and procedures.

EDUCATION, EXPERIENCE & TRAINING REQUIRED

Bachelor’s degree or equivalent work experience

Five plus years of administrative assistant or specialist experience in a health plan environment preferred

ESSENTIAL FUNCTIONS—PHYSICAL POSITION REQUIREMENTS; MACHINES AND/OR EQUIPMENT USED

Regularly required to operate standard office equipment (personal computer, photocopy machine, fax machine, etc.)

Ability to work on a computer up to 7 hours a day.

Regularly required to sit for long periods of time, and occasionally stand and walk.

Regularly required to use hands to operate computer and other office equipment.

Close vision required for computer usage.

Occasionally required to stoop, kneel, climb and lift up to 25 pounds.

WORKING CONDITIONS

Standard office environment without unpleasant or hazardous conditions. Work entails typical physical demands involved in office work.

NOTE: This description is not intended to be construed as an exhaustive list of duties, responsibilities or requirements for the position. This position may change or assume additional duties at any time. The employee may be requested to perform different or additional duties as assigned.

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