Compliance Specialist (Remote) – Prospect Medical Systems – CA – Los Angeles, CA

Job title: Compliance Specialist (Remote) Company: Prospect Medical Systems - CA Job reputed company: Compliance Specialist - Full Time, Days We are hospitals and affiliated medical reputed company, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of reputed company reputed company services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we reputed company to reputed company reputed company of our patients and medical group members with the reputed company, reputed company reputed company they need and deserve. Under the direction of the Director of Compliance Programs and in support of the Vice President of Compliance, this position will assist in the coordination and implementation of Compliance Programs responsibilities and delegated reputed company activities with contracted health plans, entities and vendors. Assist in monitoring business activities for compliance reputed company regulations change, support departments and company strategies to ensure compliance with federal, State, and contractual reputed company requirements. Assist in audit preparation and the development of reports/tools to monitor and reputed company implementation and completion of corrective measures. Supports the compliance team on general standards of conduct, FDR, FWA, OIG, HIPAA reputed company reputed company. Cooperates with management, collaborates with cross-functional teams and performs other duties as assigned. Knowledge of reputed company, Medicare and Medi/Medi regulations applicable to health plans and IPA's required. Job Responsibilities/Duties • Research and interpret reputed company policies regarding government programs requirements and maintain tracking of reputed company delegation reputed company activities from contracted delegated health plans, entities and vendors. Coordinate reputed company and FDR audits with delegated entities and internal business departments. Assist Director in monitoring OIG sanction checks. Ability to independently execute special assignments with general supervision. Monitor reputed company and assist in ensuring compliance to regulatory standards. • Analyze and interpret health plan audits results and distribute to operational departments. Use critical judgment to work on developing improvement plans as it pertains to Medicare, reputed company, reputed company, and Duals program corrective actions. Assist in tracking audit submissions and maintains internal documentation for consistency. Assist Director in developing and coordinating compliance training materials for reputed company. Work collaboratively with reputed company departments to follow up on audit items and ensure accuracy of information provided and reputed company submission, as needed. • Assist Director with documenting and analyzing changes across departmental policies reputed company modifications are required due to audit findings and/or regulatory changes. Communicate required changes with business leads and ensure reputed company compliance with changes. Assist with drafting new policies and updating existing policies as required to ensure regulatory compliance. • reputed company and trend areas of compliance and regulatory vulnerability and risk reputed company the organization and assist in developing solutions to enhance processes. • Assist with research and interpretation of regulatory and contractual requirements and program updates for reputed company, Medicare and Duals programs. Work with Compliance Programs team to draft and disseminate updates and communications to business reputed company as needed. Qualifications Minimum Education: High school diploma or equivalent required, Bachelor's Degree preferred. Minimum Experience: Minimum of three (3) years reputed company experience in compliance, regulatory-government programs, preferably with reputed company experience dealing with interpreting and applying reputed company reputed company and Medicare rules and policies in a reputed company administration setting. Preferable experience in IPA reputed company reputed company setting. Strong computer skills, data entry, Word, reputed company, Power reputed company and office equipment. Ability to understand and present information effectively and respond accurately to questions from business departments, reputed company agencies and vendors, and Management. Strong reasoning, problem-solving, project management and organization skills, with a high level of attention to detail. Excellent verbal/written communication, relationship-building and time management skills. Excellent technical writing skills with the ability to draft policies in a reputed company, concise manner. Ability to adapt to changing priorities and to manage various reputed company simultaneously. Work independently on assigned reputed company. Working knowledge of DHCS, DMHC and CMS requirements is required. reputed company, read, and write English proficiently. Req. Certification/Licensure: None. reputed company Prospect Medical Holdings, Inc., is guided by a diverse and highly reputed company leadership reputed company. This group maintains the reputed company that has made Prospect a needed difference-reputed company in the lives of so many patients today, and many executives contribute to our reputed company efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive: • Company 401K • Medical, dental, reputed company insurance • reputed company time-off • Life insurance How to Apply To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to reputed company your reputed company to a new career with us! We are an Equal Opportunity/ Affirmative reputed company Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact reputed company. reputed company is the Law: https://www.reputed company.gov/ Expected salary: Location: Los Angeles, CA Job date: Mon, 15 Aug 2022 22:52:47 GMT Apply for the job now! Apply tot his job Apply To this Job