Compliance Coordinator / Job Req 721743130

PRINCIPAL RESPONSIBILITIES:

The Compliance Coordinator will support the Compliance Department's initiatives by ensuring adherence to legal standards and in-house policies. They will be instrumental in the effective support, coordination, and monitoring of compliance activities within the managed care health plan. The role involves collecting and building comprehensive reports that reflect the health plan's compliance status and communicating with delegates and external partners to ensure alignment with compliance objectives. The Compliance Coordinator will also be responsible for other duties as assigned, demonstrating flexibility and adaptability to meet the evolving needs of the department.

Principal Responsibilities:

• Audit and Monitoring: Assist with comprehensive audits of the health plan's operations and the delegated entities to ensure compliance with all applicable laws, regulations, and standards. Assist in monitoring the effectiveness of compliance controls and recommend improvements.
• Delegate Reporting: Coordinate intake and track the delegated entities monthly, quarterly, ad hoc, and annual reports including audit documents and corrective action plans.
• Policy Development: Draft, revise, and disseminate compliance policies and procedures across the organization. Ensure that all policies are up-to-date and in alignment with regulatory changes.
• Training and Education: Develop and deliver training programs to educate employees on compliance requirements, ethical conduct, and the consequences of non-compliance.
• Investigations: Assist in the investigation of reported compliance issues or irregularities. Work closely with the Manager, Compliance Audits & Investigations to resolve issues and implement corrective actions.
• Reporting: Prepare and submit regular reports on the status of compliance activities to the Chief Compliance Officer and other senior management.
• Collaboration: Work with department leaders and other key stakeholders to foster a culture of compliance throughout the division and organization.
• Regulatory Liaison: Act as a point of contact for regulatory bodies and external auditors. Assist with coordination of responses to external requests for information and documentation.
• Risk Management: Identify potential areas of compliance vulnerability and risk. Develop and implement corrective action plans for resolution of problematic issues.
• Committee Process & Minutes Drafting: Support the preparation and execution of Compliance Division Committees and related affairs. Support the Division in completing minutes within specific timeframes following the conclusion of Committees.
• Special Projects: Complete other special projects and duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB:

• Coordinates intake of incidents and violations reported to the Compliance and Privacy Department
• Collaborates with internal and external partners to retrieve program monitoring reports and support annual auditing activities.
• Supports the daily operations of the Auditing Team, Special Investigations Unit, Regulatory Affairs & Compliance & Privacy Office email referrals and intake process.
• Effective public speaking, written and verbal communication skills.

PHYSICAL REQUIREMENTS:

• Constant and close visual work at desk or computer;
• Constant data entry using keyboard and/or mouse;
• Constant sitting and working at desk;
• Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person;
• Frequent lifting of folders and various objects weighing between 0 and 30 lbs;
• Frequent walking and standing;
• Occasional driving of an automobile;
• Occasional travel between offices for meetings; and
• Possible travel by aircraft.

Number of Employees Direct Supervision: 0

Number of Employees In-Direct Supervision: 0

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• Bachelor's degree in a related field or equivalent work experience in a health/regulatory environment.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Minimum three years related administrative experience, preferably in a managed care setting.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Strong understanding of managed care operations and/or compliance requirements preferred.
• Excellent interpersonal skills and can work effectively with staff at all levels.
• Ability to communicate effectively and provide constructive feedback.
• Proficient in developing and maintaining tracking and reporting tools for compliance assessment.
• Strong oral and written communication skills with the ability to communicate professionally, effectively, and persuasively to diverse individuals;
• Strong decision-making, organizational, planning and problem-solving skills, and communication skills are a needed to effectively interact with staff, team members and others in a professional and tactful manner;
• Ability to handle confidential information with appropriate discretion;
• Strong presentation skills with the ability to tailor presentations to a specific audience, and address and interact with large groups.

SALARY RANGE $69,606.86-$104,410.30 ANNUALLY

The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.