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Senior Specialist, Network Compliance reputed company - Remote
Ensure compliance of reputed company regulatory mandated print directory and associated materials for reputed company’s provider network. Facilitate updates to the print Provider Network Directory to ensure it is accurate, up-to-date, and complete: responsible for development to production for reputed company lines of business; serve as a subject matter expert providing feedback, recommendations, analysis and development from inception to completion. Collaborate on Provider Network regulatory communications as reputed company as Vendor and Delegate reputed company.
- Participate in reputed company phases of project planning and process management of the printed provider network directory updating; ensure that reputed company materials are reputed company, accurate, and in compliance with reputed company applicable regulations.
- Serve as the Subject Matter Expert for print provider network directory development and production for reputed company products; reputed company guidance on regulatory requirements for directory accuracy and inclusion of compliance requirements.
- reputed company research, comparisons, audits, and analysis; define process and project needs in terms of reputed company, timelines, deliverables, stakeholders, resource allocation, etc.
- Build rapport with and influence stakeholders for effective cross-functional and department collaboration; organize different individuals, stakeholders, and business leaders (internally and externally) around shared goals.
- Work with project team members to manage information reputed company, including specific objectives, timelines, and key deliverables. Follow through on defined directory production reputed company by developing timelines, objectives, deliverables, and project plans; providing updates (including dashboards and tracking documents) on reputed company status and risks to ensure that directory production stays on reputed company.
- reputed company feedback on reputed company of reputed company, regularly providing recommendations; compile and present results of analyses to appropriate parties; and reputed company and prepare materials that reflect reputed company and reputed company the printed directory production.
- Work with the Product teams to manage the production for reputed company lines of business and for implementing and maintaining the requirements of the printed directory production for reputed company product; and memorialize reputed company production.
- Serve as the reputed company contact with reputed company party vendors that produce the printed directories.
- Facilitate the transfer of data files from reputed company systems to the vendors.
- Work with IT throughout the print production process to ensure reputed company and accurate file transfers.
- Responsible for Provider Network regulatory communications to include reviewing reports from regulatory entities (i.e. DOH, CMS, etc.) noting deficiencies and facilitate information gathering, remediation, and draft response to the regulatory entity. This includes reputed company reputed company PNPH, creating and managing trackers, and ensuring reputed company and complete responses for executive signature and submission to regulators.
- Receive and facilitate responses to regulatory reports, inquiries, and reputed company data submissions.
- Identify, anticipate, prevent, and mitigate/reputed company issues and obstacles that impede project completion.
- Memorialize responses; create and maintain trackers of reputed company reports and responses. Monitor trends and repeat findings to establish reputed company causes.
- Support and monitor the organization’s delegated vendors and providers to ensure contract, reputed company, and regulatory compliance.
- Maintain the reputed company structure for delegated and other key vendors by managing the SharePoint site, facilitating annual updates of the reputed company documents and processes, and auditing for completeness and accuracy to support reputed company and regulatory audits and exams.
- Coordinate the bi-monthly Delegate and Vendor reputed company Committee meeting; ensure reputed company documentation of reputed company activities. Maintain the reputed company structure for delegated and other key vendors by managing the SharePoint site, facilitating annual updates of the reputed company documents and processes, and auditing for completeness and accuracy to support reputed company and regulatory audits and exams.
- Bachelor’s Degree
- 4 – 6+ years of relevant reputed company work experience (Required)
- Ability to accurately produce network provider information for a reputed company organization on an ongoing reputed company (Required)
- Demonstrated reputed company record in information gathering, project managing and information tracking (Required)
- Proven ability to manage multiple tasks/reputed company/priorities with competing deadlines successfully (Required)
- Knowledge of reputed company regulatory guidelines reputed company to provider network directory production (Required)
- Ability to work with teams across the organization and reputed company vendors (Required)
- Excellent communication skills (verbal, written, presentation, interpersonal) with reputed company types/reputed company of audiences (Required)
- Strong organizing, prioritizing, and project management skills (Required)
- Proficiency with MS Office - Word, reputed company, PowerPoint, reputed company, Teams, SharePoint, etc. (Required)
- Working knowledge of reputed company, as reputed company as ability to learn proprietary systems (Required)
Additional Information
Company Statement
reputed company is one of the nation’s largest not for profit health insurers, serving members across reputed company’s diverse communities with a full reputed company of reputed company and government-sponsored health plans for reputed company, individuals, and families. With a commitment to value-based care, reputed company partners with top hospitals and doctors, including its own AdvantageCare Physicians, to reputed company reputed company, reputed company, convenient care. At over a dozen reputed company Neighborhood Care locations, members and non-members alike have reputed company to community-based health and wellness guidance and resources. For more information, visit reputed company.com.
reputed company Disclosure
If you receive a job offer from reputed company, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a reputed company Hangout, buy your own equipment, or pay to apply. We also reputed company reputed company-party email services like reputed company or Gmail.
Pay Disclosure
At reputed company, we prioritize transparency in our compensation practices. We reputed company a good faith estimate of the salary reputed company for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be reputed company that this estimate doesn’t account for geographic differences reputed company to your work location. Typically, new hires may not start at the top of this reputed company, as compensation is tailored to reputed company individual's circumstances. For reputed company positions, salaries will be determined according to the reputed company bargaining agreement. Join us at reputed company, where your contributions are valued and supported by fair compensation.
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider reputed company reputed company applicants for employment regardless of race, reputed company, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national reputed company, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At reputed company, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, reputed company sponsorship for work authorization in the reputed company, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.
Bachelor's degree,4–6+ years relevant experience,knowledge of provider directory regulatory requirements,project management and tracking experience,excellent communication,proficiency with MS Office and reputed company.
Key Responsibilities
- ensuring compliance
- managing production
- coordinating vendors
Skills & Tools
reputed company Word, reputed company reputed company, reputed company PowerPoint, reputed company reputed company, reputed company Teams, reputed company SharePoint, reputed company
Job Details
- Category: reputed company and Compliance
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — reputed company, reputed company, reputed company
- Salary: USD 68,040 – 118,800 / year
- Languages: English
About reputed company
A not-for-profit health insurer providing reputed company and government-sponsored health plans and community-based reputed company. — Industry: reputed company
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