Compliance Operations Manager

Walnut Creek  ‐ Onsite
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Keywords

Description

A healthcare provider is currently seeking for a Compliance Operations manager to join their team in Walnut Creek.
Responsibilities:
  • The Compliance Operations Manager is responsible for managing/coordinating network-wide compliance with federal, state and local health care industry laws applicable to the healthcare provider, including Centers for Medicare and Medicaid Services (CMS), Office of Inspector General (OIG), California Department of Managed Health Care (DMHC), California Department of Insurance (CDI) and United States Department of Health and Human Services (HHS) requirements pertaining to programs such as Medicare Advantage, Medicare ACO, HIPAA, Fraud, Waste & Abuse detection, and Knox-Keene regulations.
  • The Compliance Operations Manager serves as the resource for all staff within the organisation regarding compliance and regulatory questions and is the main point of contact to receive and direct compliance issues to appropriate resources for resolution


Qualifications and experience:
  • Bachelor's degree.
  • CHC Certification preferred.
  • Prefer at least five years of experience in increasingly responsible positions in a complex healthcare organization including experience in compliance and privacy, billing and coding regulations, policies and processes.
  • Knowledge in Medicare, Medicaid, DMHC, private payer requirements and HIPAA.
  • Excellent written and verbal communication skills.Ability to express complex issues and situations in clear and understandable terms. The ability to understand and carry out oral and written instructions and to request clarification when needed.
  • Understanding of revenue cycle and reimbursement for federally funded programs.
  • Experience in Medicare reimbursement coding, ICD and CPT procedure coding.
  • Ability to interpret regulatory and legal information and discuss relevancy with leadership; to create and deliver presentations to staff, management, and regulators; and to write, maintain current, and implement policies and procedures.
  • Ability to motivate, develop and direct people to accomplish objectives.
  • Uses sound judgment making decisions in the best interest of the organization to drive results given direction in the form of assigned goals and objectives.
  • Expertise in data gathering, management, reporting and interpretation.


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This position is for a one year contract with potential for extension or conversion. Do not hesitate to apply today as this healthcare provider is very eager to hire.
Start date
08/2014
From
Real Staffing
Published at
23.07.2014
Project ID:
746212
Contract type
Freelance
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