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Years of Experience
Date Last Verified
Compliance Analyst - Compliance and Privacy Specialist The candidate will manage and coordinate compliance related processes. Will monitor governance and compliance of rules, regulations, policies, and procedures and assist with appropriate audits, as applicable. Contacts may include legislators, consumers, special interest groups, advocacy agencies, CMS and other regulatory bodies such as DPW. Ensure systems are updated and accurate for compliance. Responsible for understanding and applying accreditation and regulatory requirements. May support Regulatory Compliance department to ensure all state renewals, applications, and annual reports are completed accurately and timely. Depending on department may be responsible for one of the following: the delegation oversight of subcontractors when applicable to ensure compliance with health plan standards and policies and regulatory bodies; performing and providing oversight of the care management delegation functions of multiple vendors through review of annual assessments, monthly performance reporting and analysis of reports to ensure adherence to regulatory and accreditation standards. Other duties as assigned or requested.
Qualification and Experience
The candidate should have High School Diploma/GED. Must have 2-5 years of relevant subject matter experience in the area of specialization. Law Degree and/or Healthcare Compliance Association certification (HCCA) is preferred. Experience in one or more of the following: healthcare operations, compliance, auditing, investigations, regulatory accreditations, process improvement, project management and/or managed care operations is preferred. Experience analyzing legal requirements and standards is preferred. Audit experience is preferred. Proficiency with Microsoft Office software programs and database query tools, and other Internet and Intranet applications and databases is preferred.
Job ID: J114212
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