Compliance Analyst - San Jose, United States - Santa Clara Family Health Plan

Santa Clara Family Health Plan

Verified Company

San Jose, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

About Us:

Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County.

Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) health care plans.

About the role:

The Compliance Analyst researches, plans, implements, and monitors a broad portfolio of compliance programs and initiatives to enable organizational compliance with all applicable Federal, state, and local regulations/laws.

On an on-going basis, researches and interprets regulations and laws to establish compliance standards, and may develop and/or deliver training and/or communications relative to new standards.

May be responsible for project management relative to new compliance initiatives, products, or annual processes

Day to Day:

Implement, support and enforce SCFHP's Privacy Program; assist in updates and revisions to the Privacy Program as needed or required by law to ensure SCFHP's compliance with state, federal and international privacy laws; implement, support, and enforce best practices to protect the privacy of members' protected health information (PHI).
Build strong relationships and collaborate with business units to promote the Privacy Program and encourage privacy compliance at all levels of the organization
Assist as requested in the timely creation, review, revision and updates to privacy policies, desk level procedures, resource guides, job aides and other educational tools
Act as a liaison with regulatory enforcement agencies; cooperate and participate as required by technical assistance letters, investigations, compliance reviews, audits and other reviews made by regulatory agencies, including CMS, OCR, DMHC, and DHCS.
Provides project management, coordination, and analytical support for compliance projects. Provides consultation on internal and external requirements. Evaluates regulatory requirements and potential operational impacts.
Assists in the identification of compliance program needs, and develops strategies, plans, and documentation for programs and related initiatives.
Supports the Manager, Compliance (Medi-Cal/Medicare) by designing, documenting and implementing process improvement initiatives within the department.
Supports and when directed, leads the Compliance Work Group and other crossfunctional work groups.
Assists in leading the development and maintenance of health plan FWA program capabilities and offerings.
Supports compliance audits, risk assessments and ongoing compliance monitoring activities, including the coordination of data requests.

About You:

Bachelor's Degree in Business, Healthcare Administration or a related field or equivalent experience, training or coursework.
Minimum 3 years progressively responsible compliance experience in a healthcare or managed care environment. A Master's Degree may be substituted for one year of required experience.
Knowledge of health care compliance policies, practices and systems.
Ability to analyze and interpret data to identify trends.
Ability to maintain detailed and accurate records; follow oral and written directions; prepare written agendas, transcribe minutes, and develop reports.
Ability to conduct all necessary research, root analysis and trends to accurately identify complex issues.
Ability to consistently meet compliance accuracy and timeline requirements according to regulatory requirements.

Please review the full job description on our Career's page:

Pay:
$80, $120,642.00 per year

Experience: