Compliance Specialist

Compliance Specialist

The Compliance Specialist will support the oversight and management of JCCA's regulatory compliance activities, including performing audits, investigations, and risk assessments to understand risk level, significance, and scope. Keep up to date with, and understand, relevant laws and regulations. Monitor compliance with laws, regulations, and internal policies. Contribute to the annual Compliance risk analysis and Work Plan. Ensuring the JCCA Compliance plans and related Compliance training are accurate and updated.

Job Description

• Contribute to the annual risk assessment and work plan, ensuring the gathering and provision of regulatory compliance related information.
• Conduct regular chart reviews of Medicaid billing programs to monitor compliance with regulations
• Compose and revise high level policy and procedures for ALL agency programs / departments
• Supports the regular development and review of Compliance policies and procedures for the general operation of the Plan's compliance program and its related activities for CMS and JCCA lines of business.
• Contributes quality and timely data for both the internal Compliance Committee meetings and the Audit and Compliance Subcommittee of the Board of Directors.
• Synthesizes regulatory guidance into Compliance activities and track related due dates and provide support to the business areas completing deliverables.
• Possess knowledge of government regulations, guidelines, and agency policies and procedures applicable to program.
• Assist with the management of client records request by performing supportive tasks
• Conduct root cause analysis and submit corrective action plans, with guidance on methodology and identification of relevant regulatory requirements to programs.
• Plays a critical role in driving the progress for corrective actions throughout the organization.
• Ensures thorough investigation of all issues reported to the anonymous Hotline.
• Assist in the development and facilitation of compliance related trainings
• Represent the department and agency at internal and external meetings as needed
• Other duties as assigned or requested

Qualifications :

Compensation : $32.97 - $35.71