IT - Compliance Administrator

Mindlance

MASON, OH

Apply

JOB DETAILS

SKILLS

Comparative Analysis, ERISA (Employee Retirement Income Security Act of 1974), Federal Government, Healthcare Management, Information Systems/Technology IS/IT Administration, Insurance, Leadership, Maintain Compliance, Managed Care, Medicare, Operations Processes, Policy Development, Procedure Development, Regulatory Compliance, Regulatory Reports, Regulatory Requirements

LOCATION

MASON, OH

POSTED

18 days ago

GENERALFUNCTION
The Administrator-Compliance (Programs)is responsible for preparing, researching, and completing the regulatory reports, amendment filings, and business partners/carrier reporting requirements. This includes operational processes and programs to assure compliance with various regulatory requirements such as Medicare Advantage (MA),
Department of Managed Health Care (DMHC), Department of Insurance(DOI), and Employee Retirement Income Security Act (ERISA).
Compares and evaluates possible courses of action and makes recommendations to the Compliance Manager or leadership team. Assists the Compliance Manager in assuring compliance with policies, procedures, and requirements set by state and federal agencies. Modifies policies and procedures as necessary.

MAJORDUTIESANDRESPONSIBILITIES
a Thoroughly prepares,researches, and completes DMHC reports and amendment filings,business partners/carrierreportingrequirements, and any other requirements set by state and federal agencies. Reviews related regulations and performs analysis to assure all requirements are met and filed within the deadline.
a Thoroughlyandtimelytracksreportingdeadlinesbymonthandlogsallin-processandcompletedreports.
a Preparesand/oroverseesinternalclaimsandqualitymanagement/utilizationmanagementauditresultsandfindingsincollaborationwiththeManager-Compliance,ClaimsManager/TeamLeader,andQualityManagementVP/TeamLeaderandClinicalDirector.
a PreparesdocumentstobepresentedtotheQualityManagementCommittee,PublicPolicyCommittee,BoardofDirectors,andManagementTeam.
a Providesoversightwiththecomplianceworkplanandmonitoringfunctionsandactivitiesincludingriskassessment.
a AssistswiththeLanguageAssistanceProgram(LAP)activitiessuchasstafflanguagefluencyassessment,monitoringtheenrolleeassessmentreport,CustomerServiceDepartmentcalllog,andpreparingandmai
Preparesreports,maintainsfiles,andcommunicatesthedata&informationassociatedwithlocal,state,andfederalregulatoryguidelinesforthenetworkincludingthosesetforthbyEPA,StateEPAa TMs,CalEPA,CaliforniaCUPAa TMsandotherstateandlocalenvironmentalregulatoryagencies.Supportscompliancewithfederal,state,andlocalenvironmentallaws
a AbilitytoworkeffectivelywithregulatoryagenciesisrequiredwhilecommunicatingwithfacilitiesthroughoutU.S.andCanadaregardingpermits,inspections,andcompliancerequirements
a Maintaingeneralanduptodateknowledgeoffireprotectionsystemsandassociatedgeneralregulatorycompliancerequirements
a Acquireapprovalforenvironmentalcompliancerelatedpayablesandtrackinvoices&checkrequests
a ManageWaterDischargeMonitoringReports
a GeneralknowledgeofSPCCplansandStormwatermanagementplansastheyrelatetoouroperations
a FamiliaritywiththeCleanAirActasitrelatestoouroperations
a FamiliaritywithEPCRArequirementsastheyrelatetoouroperations
a GeneralknowledgeofCaliforniaspecialwastesastheyrelatetoouroperations
a GeneralunderstandingofEnvironmentalManagementSystems
a Maintaindocumentfilespertainingtoaudits&observationsofworkforceperformancewithregardtoenvironmentalcompliance
a Throughobservationofdocumentssuchasreports,permits,&inspectionforms,beabletodetectpotentialenvironmentalcomplianceproblemsofanaccounting,bookkeeping,andclericalnature.
a Facilitate,arrange,andconductenvironmentalrelatedtrainingandorientationasneeded
a Trackinformationonenergyandresource-efficientprojects&programs.ThiscouldincludeenergyconservationprogramsandfutureLEEDcertifications.
EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

IT - Compliance Administrator

Mindlance

MASON, OH

About the Company

Mindlance

Similar Job Searches