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Organization TypePublic Interest
Years of Experience
Date Last Verified
ProfileRegulatory Affairs and Compliance Analyst The candidate will work with a high degree of autonomy to provide support and lead a broad range of activities where you will flex your excellent judgment and decision-making abilities. Will grow as you demonstrate your extensive knowledge of State health care programs and requirements, and gain additional knowledge 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). Provide timely responses to State inquiries, including ad hoc inquiries, State Fair Hearings, Independent Medical Review requests and Consumer Complaints. Analyze Compliance Program reports for trends and and identify the need for corrective action. Oversee and conduct internal audits as assigned. Coordinate audits by governmental agencies. Train staff on various aspects of new legislation, contracts, compliance, HIPAA and other regulations. Lead organizing, tracking and responding to subpoenas and liens for all SFHP lines of business. Lead the implementation of SFHP’s business continuity plan. Serve as one of the department liaisons with state agencies. Analyze and coordinates the implementation of new regulations and legislation as assigned. Ensure smooth functioning of assigned area of responsibility. Coordinate activities between departments as relevant to the Compliance and Regulatory Affairs department. Appropriately refer substantive questions / key business issues to others and follows up to ensure resolution on behalf of the manager. Assess problems and develops solutions following general policies and procedures. Perform special assignments for the 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. Assist with department budget, including processing invoices and variance reports.
Qualification and Experience
Qualifications: Bachelor’s degree or equivalent combination of education and work experience. JD Degree preferred. Healthcare Compliance Certification preferred. 5+ years of administrative assistant or specialist experience, ideally in a health plan environment . Strong working knowledge of State program regulations and HIPAA Superior critical thinking and problem solving abilities Exceptional communication abilities and organization skills Advanced proficiency with MS Office applications (Word, Excel, PowerPoint). Must be extremely professional, organized, be able to demonstrate high standards, integrity, confidentiality, enjoy interacting with people at all levels, and thrive in a fast-paced environment.
Job ID: 2017-1172