Senior Compliance Advisor- Internal Auditor

California  ‐ Onsite
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Description

Description:
  • Along with the Compliance Officer, Privacy & Information Security Officer, and the Compliance Program Manager, the Senior Compliance Advisor, State Programs serves as the focal point for all compliance activities.
  • Coordinates and communicates all assigned state program compliance activities internally and with contracted provider network
  • Ensures that company and it's subcontracted provider network is compliant with all state regulatory requirements.
  • Along with the Compliance Officer, this individual is the liaison with DHCS and DMHC and other state agencies concerning product(s).
  • This is achieved by working with internal and external staff to correct performance deficiencies, ensuring staff are aware of state reporting requirements and reports are submitted to agencies identifying internal areas for improvement.
  • Senior Compliance Advisor is responsible for performing internal audits, monitors implementation of corrective measures, and interpretation of DHCS, DMHC and NCQA standards.
SKILLS:
  • Working knowledge of state requirements is required, as well as highly developed analytical skills and excellent written and verbal communication skills.
  • Must have the ability to manage multiple priorities and projects and meet deadlines.
  • Excellent oral and written communication skills.
  • Demonstrated analytical skills and delivering training programs and making presentations to staff and providers.
  • Must possess a strong understanding of Medi-Cal laws and regulations and other state programs
  • 5 to 7 years in a managed care setting with at least one year working with an MCO's Medicaid product
  • Masters degree in Business Administration, Public Health, or Healthcare Administration
  • In lieu of Master's degree, relevant 7 years experience
  • Supervisory experience.
  • Two or more years of internal auditing experience for a health plan or healthcare system,
  • Juris Doctor from ABA accredited law school
  • Certified Health Care Compliance Professional
Start date
n.a
From
Synectics
Published at
27.05.2015
Project ID:
911713
Contract type
Freelance
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