Compliance Specialist

Job Details Level : Experienced Job Location : East 3rd St Health Center - Los Angeles, CA Position Type : Full Time Education Level : Bachelors Degree Salary Range : $35.50 - $44.48 Hourly Job Shift : Day Job Category : Health Care

SUMMARY :

Under the leadership of the Director of Risk & Compliance, the Compliance Specialist monitors, executes, and enforces Gracelight Community Health Compliance Program. The Compliance Specialist works directly with management and staff and is the primary contact for the delivery of compliance level engagements and training on both department-specific and organization-wide compliance initiatives. Additionally, the role assists the Credentialing Department in coordinating, monitoring, and maintaining the credentialing, recredentialing, and privileging process.

The Compliance Specialist assists with company-wide integrated risk assessments, third-party vendor management, audit management, investigates possible compliance violations and grievances, incident management, and policy and procedure management. The Compliance Specialist monitors and reports on corrective action plans and provides staff training and education.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES :

1. Supports and implements the organization’s vision, mission, and values.
2. Determines priorities and methods of completing daily workload to ensure that all responsibilities are carried out in a timely manner.
3. Fosters and promotes a culture of service excellence and accountability.
4. Performs all job functions in a professional and courteous manner, ensuring customer service orientation.
5. Performs job duties independently and exercises good judgment.
6. Manages the organization’s third-party vendor relations and contract administration.
7. Manages the organization’s document management systems to ensure compliance with filing, access, destruction, and retention policies.
8. Promotes awareness and understanding of standards of conduct and ethics.
9. Oversees, maintains, manages, tracks, and assists in the preparation and revision of organizational policies and procedures.
10. Coordinates compliance review and monitoring activities.
11. Assists with external audits and inspections conducted by contracted health plans and federal, state, and county entities.
12. Promotes, develops, and conducts compliance training and education for all staff.
13. Maintains the company’s incident management system.
14. Collaborates with other functional departments to resolve compliance issues.
15. Develops systems for tracking outcomes to ensure governmental requirements are met.
16. Maintains confidentiality in all matters related to audits, investigations, and incidents.
17. Maintains current knowledge of relevant compliance regulations, trends, and practices.
18. Oversees grievance and incident management across all related departments.
19. Complies with organizational policies and procedures.
20. Composes neat, legible, complete, and accurate documentation in a timely manner.
21. Performs other duties as assigned.

QUALIFICATIONS:

1. Bachelor’s Degree required; training in healthcare compliance preferred.
2. Minimum of two (2) years’ experience in a healthcare/health center/hospital setting desired.
3. Familiarity with contract administration and regulations desired.

LANGUAGE SKILLS:

Ability to read and interpret documents, such as policies and procedures, and communicate effectively with employees, visitors, and management.

MATHEMATICAL SKILLS:

Ability to calculate figures and amounts such as discounts, interest, and proportions.

REASONING ABILITY:

Ability to exercise common sense in carrying out instructions and deal with problems involving several concrete variables.

OTHER SKILLS AND ABILITIES:

1. Demonstrates flexibility to work in other areas of the organization as needed.
2. Able to organize and prioritize work with minimal supervision.
3. Maintains and promotes a safe work environment.
4. Demonstrates proficiency in computer applications such as Microsoft Excel, PowerPoint, Word, and Outlook.
5. Must have own automobile, valid California Driver License, and active automobile insurance.

PHYSICAL DEMANDS:

While performing the duties of this job, the employee is regularly required to use hands and arms. The employee frequently is required to stand, walk, and sit. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 30 pounds.

WORK ENVIRONMENT:

The noise level in the work environment is often low, but there may be high ambient background noise from phones and conversations.