Description:
Position Summary:
The Compliance Specialist assumes a vital role at Universal Healthcare MSO, LLC, responsible for overseeing and ensuring compliance with organizational policies, procedures, and regulatory requirements. Key responsibilities include supporting or conducting audits and assessments to monitor compliance levels, developing, and implementing compliance policies and procedures, and providing guidance and training to staff on compliance matters. Additionally, the
Compliance Specialist will be tasked with staying abreast of changes in laws and regulations affecting the healthcare industry, ensuring that policies and procedures are updated accordingly. The position also involves conducting investigations into compliance issues, recommending corrective actions and assisting in the resolution of compliance-related concerns. The
Compliance Specialist plays a critical role in promoting a culture of compliance and integrity throughout the organization.
Compensation:
The initial pay range for this position upon commencement of employment is projected to fall between $26.95 and $30.00. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.
Requirements:
Job Duties and Responsibilities:
- Manage the electronic storage of documents.
- Maintenance of the organizations document control policy which includes, but is not limited to updating policy and procedures, desk level procedures, job aides, miscellaneous correspondence.
- Maintain the organization’s comprehensive master list of documents and repository system.
- Collaborate with department heads to provide specialized guidance on policy updates, ensuring alignment with industry standards and best practices. Direct the dissemination of policies to relevant stakeholders for thorough review and approval, facilitating timely implementation of necessary revisions.
- Employ advanced proficiency in the electronic document system to generate comprehensive reports, enabling thorough compliance assessments.
- Provide specialized support in overseeing a broad spectrum of operational, business, and regulatory activities pertaining to Health Plan Partnership, leveraging in-depth expertise to ensure compliance and optimize performance.
- Engage in close collaboration with Health Plan partners, leveraging specialized expertise to facilitate seamless implementation of both new and ongoing regulatory requirements, ensuring adherence to industry standards and optimal operational efficiency.
- Provide dedicated support to overall strategic plans, goals, and direction of process improvement activities.
- Foster professional relationships with all departments, working collaboratively to achieve organizational objectives.
- Provide specialized assistance in coordinating and preparing responses to Health Plan audits, encompassing the development of internal audit tools, meticulous audit preparation, and the collection and preparation of documentation and policies, ensuring comprehensive compliance with audit requirements and regulations.
- Responsible for analyzing meeting objectives, conducting thorough research, and developing detailed agendas tailored to specific objectives. Ensures accurate documentation of meeting proceedings, including meticulous transcription of minutes,
and identifies actionable items for follow-up within assigned meetings.
- Contribute expertise to the design and implementation of the employee training program, including developing specialized training materials, conducting in-depth training sessions, and providing ongoing support and guidance to participants.
- Actively engages in all New Employee Orientations representing the Compliance Department, offering specialized insights and guidance to ensure new employees have a comprehensive understanding of compliance protocols and regulatory requirements.
- Participates on committees and teams supporting governance, compliance, and risk programs and initiatives.
- Spearhead initiatives to cultivate a culture of heightened compliance awareness and individual accountability, leveraging specialized expertise to develop targeted training programs and implement strategic communication strategies.
- Generate requested supporting reports promptly and accurately.
- Perform other duties as assigned.
Qualifications
- Bachelor’s degree preferred.
- Previous managed care compliance experience preferred.
- Familiar with Medicare and Medicaid/MediCal programs preferred.
- Preferred: Familiarity with ICD-9, ICD-10, CPT-4, and HCPCS coding.
- Preferred: One to two years of experience in Compliance and Contracts Management.
- Proficiency in collaborating with Health Care Providers.
- Demonstrated strong and effective problem-solving abilities.
- Exceptional organizational skills with a proven ability to complete projects in a timely
manner.
- Exceptional proficiency in written communication, demonstrating meticulous attention to
detail in grammar and spelling, ensuring clarity and accuracy in all written materials.
- Proficient in computer skills, with an in-depth knowledge of Microsoft Excel.