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Carrot Peelers, Sales, Personality and Your Job Search
Public Interest
Attorney
Corporate - General
Environmental and Land Use
Health Care
Min 3 yrs required
PACE Compliance Manager The candidate will provide following duties: Administer and lead the PACE Compliance Program in collaboration with the PACE Director and PACE Management team; Implement systems and processes designed to ensure compliance with applicable laws, regulations and standards (e.g., Department of Health and Human Services Departments, including the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG); Monthly monitoring/ review of the OIG exclusion list to ensure that all contracted providers are in good standing; Provide compliance monitoring, reporting, and training in collaboration with the PACE Management Team; Monitors and ensures that all compliance requirements are met in regards to the California Child and Adult Care Food Program; Ensures PACE contract compliance and conducts regular and on-going contract reviews and site visits as required. Prepares site visit reports and ensures appropriate follow through on any areas of improvement needed/required; Responsible for periodic chart reviews ensuring compliance with documentation in accordance with internal policies; Responsible for monitoring all HPMS memos as well as any other CMS correspondence and distributing them to appropriate staff; Review, monitor and ensure compliance involving Pharmastar and 340B pharmacy requirements which will include review of related reports and communication through assigned web portal; Knowledge of other disciplines outside of town area of expertise, including business planning, HIPAA privacy, clinical disciplines, human resources, finance, clinical and financial auditing, and information technology is desired; Working knowledge of federal and state reimbursement program requirements (e.g., Medicare and MediCal), federal and state anti-kickback and physician self-referral laws (e.g., Stark and PORA), and provider and practitioner licensure and scope of practice requirements, privacy and consent laws.
Qualification and Experience
The candidate must have a Bachelor’s Degree, clinical degree or clinical license. Must have certification in Healthcare Compliance or in the process of achieving certification - must be achieved within the first 90 days of hire. Must have 3+ years’ previous experience in performing the duties in a Corporate Compliance Program, Quality Assurance; and/or Risk Management. Must have experience in training and PowerPoint presentations. Must have direct work experience in a project management capacity, including all aspects of process development and execution. Must have 3+ years experience in an audit, monitoring, and tracking environment. Must have basic understanding of the San Diego PACE Program compliance requirements. Must have working knowledge of the Health Resources and Services Administration (HRSA) 330 Health Center Program requirements. Law degree is preferred.
Reference id: 449
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