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Compliance Specialist

CCHP Health Plan
San Francisco, CA
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

POSITION SUMMARY
The Compliance Specialist supports the efforts of the Compliance Officer to improve CCHP’s public presence and to provide excellent service to our existing and potential members, fellow employees, and business partners. With strong organizational skills, the Compliance Specialist assists the Compliance Officer in achieving the goals and objectives; identifies and resolves a variety of issues related to regulatory issues; maintains basic commercial regulatory files; develops and facilitates marketing materials; and prepares and submits Medicare/commercial marketing materials to federal and state regulators. This person has direct, daily contact with CCHP and Chinese Hospital managers, and other office staff persons.

ESSENTIAL DUTIES AND RESPONSIBILITIES
• Assists with regulatory filings into the Department of Managed Health Care (DMHC) and Centers for Medicare and Medicaid Services (CMS) protocols.
• Assist the Compliance Officer to monitor the day-to-day compliance activities.
• Assist with conducting the compliance risk assessment and assist with internal audit and monitoring activities.
• Assist organization with internal, external, and regulatory audits.
• Provide guidance and assistance to CCHP departments in statutory and regulatory requirements
• Assist the Compliance Officer with responding to compliance hotline reports, department calls, reports of non-compliance, or other contacts. Assist with strategizing potential solutions and their implementation, including but not limited to compliance review spot-checks, training sessions, or policy revisions.
• Perform ongoing compliance reviews to detect or confirm compliance violations.
• Proactively cultivates and maintains strong, positive working relationships.
• Maintains confidentiality of all information related to members, medical staff, employees, integrity issues, audits, and, as appropriate, other information.
• Assists with or leads the development of compliant marketing materials.
• Assists in performing presentations on educational trainings.
• Stays knowledgeable and up-to-date with compliance of regulatory requirements.
• Follows established and newly implemented changes in departmental policy.
• Accepts and performs other duties as assigned.

QUALIFICATIONS
• Bachelors degree or equivalent in Business Administration, Health Care or related field
• Two years prior experience in a health care environment
• Strong interpersonal and communication skills and ability to work effectively with a wide range of constituencies
• Excellent time management, organizing and coordinating skills
• Ability to make rational judgments on sensitive and confidential issues
• Ability to set and change priorities quickly and as the situation warrants
• Strong skills in Microsoft applications including MS Office: Word, Excel, PowerPoint, and Outlook
• Follows directions carefully and completely
• Works efficiently to maximize productivity
• Strong written and verbal skills
• Ability to read and write Chinese preferred
• Professional in manner and appearance

CCHP Health Plan

Address

445 Grant Ave

San Francisco, CA
94108 USA

Industry

Business

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