Essentials Functions:

• Oversees the development and maintenance of a well-structured regulatory and compliance monitoring process, collaborating with key members of management and other departments.
• Successful performance, time/budget management, progress metrics, and effective report modifications are used to control and ensure the completion of auditing tasks.
• Provides key company executives with monthly and/or request reporting on the compliance plan, timetables, and status.
• Conducts all necessary investigations into non-compliance with state and federal laws and regulations, healthcare use, and business policies and procedures.
• Any incidents of non-compliance with state and federal laws and regulations that are detected or referred to the Compliance Officer and Committee are reported.
• Produces detailed reports and statistical analysis based on all instances of noncompliance with state and federal laws and regulations, as well as healthcare use and business policies and procedures.
• Elaborates and conducts compliance trainings in collaboration with the compliance manager
• Provides direct assistance in the preparation, coordination and tracking of: Compliance plans, Compliance Committees, Compliance trainings, enforcement of corrective action plans and policies and procedures review & development

Requirements:

• Bachelor's degree in business administration, managed care or behavioral health field (Master's degree preferred).
• Minimum 3 years of experience in auditing, financial auditing, compliance, healthcare, care management or related field preferred.
• Understanding of the healthcare business and how managed care works
• Awareness of auditing procedures and work plans is desired, as as knowledge of contemporary fraud, abuse, and waste prevention strategies.
• Working with Microsoft Word, Excel, Power Point, and Outlook at an intermediate level is required for personal computer experience.
• Strong analytical capabilities and a track record of problem-solving abilities.
• Professional communication abilities, including the capacity to accurately explain thoughts and ideas, both verbally and in writing
• Strong communication abilities, both verbally and in writing.
• Must have a track record of creating high-quality work that exhibits attention to detail and reflects favorably on the company.

Equal Employment Opportunity.

This opportunity may require full Covid-19 vaccination and/or submit the duly documented exemption. People with exemption are subject to weekly COVID testing to maintain employment.

Job Type: Full-time

Salary: $27,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• What is your hourly wage expectations? *
• Are you currently unemployed or will you be soon?

Education:

• Bachelor's (Preferred)

Experience:

• Data Entry: 1 year (Preferred)
• Case management: 1 year (Preferred)
• Compliance: 3 years (Preferred)
• Financial auditoring: 3 years (Preferred)
• Care Management: 3 years (Preferred)
• Healthcare: 3 years (Preferred)

Language:

• English very fluently (Preferred)
• Spanish very fluently (Preferred)

Work Location: One location

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