** MUST BE WILLING TO PHYSICALLY WORK NEAR SUNRISE, FLORIDA, 33323**
Reporting directly to the Vice President, Compliance & Privacy Officer, this position supports the Community Care Plan Compliance Program by developing and implementing content for compliance and privacy education and training; conducting and/overseeing compliance and privacy audits and investigations; participating in the development and maintenance of policies and procedures; and serving as a compliance and privacy resource.
- Bachelor’s degree or equivalent education and experience required.
- 5-8 years regulatory healthcare compliance experience.
- 3-5 years works for management experience required
- Knowledge and experience with Florida Medicaid required
- Knowledge and understanding of Florida Healthy Kids Program (CHIP) preferred
As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule. Staff are able to work from home 3 days a week and will report to the office 2 days a week.****
* The company reserves the right to change the work schedules based on the company needs.
Essential Duties and Responsibilities:
- Assists in the development and implementation of Annual Compliance Work Plan and Annual Compliance Audit Plan.
- Maintains and reviews contract and regulatory documentation necessary to maintain compliance and privacy standards.
- Manages and supports the review and revision of operational policies and procedures to ensure compliance with contract and state and federal laws and regulations.
- Creates, implements, and maintains compliance and privacy policies and procedures.
- Creates, implements, monitors, and tracks compliance and privacy training and education.
- Conducts compliance audits to review established and newly executed operational processes and controls to ensure compliance with contract and state and federal laws and regulations
- Conducts compliance and privacy risk assessments and develops and monitors progress with corrective action plans when applicable.
- Assists in the identification, analysis and resolution of compliance and privacy issues.
- Processes and documents requests for information.
- Creates and implements compliance and privacy tracking, trending, and reporting tools.
- Assists in compliance and privacy investigations.
- Acts as a compliance and privacy resource for operational departments.
- Provides guidance to various operational departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language.
- Leads Compliance/SIU team members.
- Assists in special investigative unit activities as needed to ensure program integrity compliance.
This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.
Skills and Abilities:
- Planning, organizing and prioritizing work activities and the ability to manage several tasks at once.
- Effectively communicate in writing.
- Knowledge and experience with Florida Medicaid required.
- Knowledge and understanding of Florida Healthy Kids Program (CHIP) preferred.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear.
The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 15 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Clipped from: https://www.learn4good.com/jobs/online_remote/finance/1015366259/e/