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Imperial Health Plan of California, Inc. · 2 weeks ago

Health Plan Compliance Specialist

Pasadena, CA

Full-time

Onsite

New Grad, Entry Level

$72K/yr - $77K/yr

Imperial Health Plan of California, Inc. is seeking a Health Plan Compliance Specialist to support their Compliance Department. The role involves assisting with regulatory audits, developing policies and procedures, and serving as a resource for compliance-related information.

ConsultingHealth CareHealth InsuranceInsurance

Hiring Manager

Ginny Mutton

Responsibilities

Serve as the UM Compliance Specialist with Delegated Health Plan contacts for reporting deliverables. Track due dates and deliverables

Assist UM Lead Compliance Specialist with development of policies and procedures, program plans, and work plans for IHP/IHHMG

Assist in the organization of internal and external audits, compile requested documents for UM IHP/IHHMG regulatory audits, manage audit repositories and maintain master audit dashboard. Track due dates and deliverables

Schedule meetings for UM projects and/or regulatory audits

Assist in developing presentations/reports for UM

Acts as a resource to staff, providers and/or members for UM program information

Adheres to payroll policies and properly uses a timekeeping system with minimal manual changes

Maintains regular and consistent attendance

Adheres to Compliance Plan and HIPAA regulations

Other duties as assigned to support regulatory compliance

Takes on special projects as needed and requested

Performs other duties as assigned

Attends staff meetings as required

Attends appropriate training, seminars and workshops as required

Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations and IMAS’s Standards of Conduct