We are seeking a dedicated professional to join our team in a hybrid working position. Candidates must reside in the DFW or surrounding area with access to high-speed internet and a secure work environment. All necessary equipment will be provided.
Primary Purpose
Analyze clinical and financial data to drive practice transformation, ensure quality program compliance, and enhance patient care.
Support the Compliance Manager by conducting regulatory compliance reviews to ensure adherence to laws and regulations.
Assist with operational compliance inquiries from business units.
Responsibilities
Maintain and audit compliance databases to ensure accuracy and legal compliance.
Identify documentation gaps or potential non-compliance areas and propose solutions.
Coordinate and participate in external audits, including those by CMS and state regulators.
Create compliance reports, dashboards, and summaries for leadership review.
Develop and assist with compliance policies, procedures, and training programs.
Manage relationships with regulatory agencies to address policy issues.
Foster collaborative relationships across functional areas such as legal, contracting, and quality monitoring.
Act as a resource on policies, contract issues, communications, workflows, and quality improvement initiatives.
Submission Requirements
2 years of healthcare compliance experience
Regulatory reporting and deliverables management experience strongly desired
Experience at a Managed Care organization highly preferred
Bachelor's degree in Healthcare Administration, Business Administration, or related field
Profile Requirements
Resume/Work history
Skills Checklist
Copy of Certification(s)
At least 1 reference
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