Compliance Specialist - Los Angeles, CA

L.A. Care Health Plan serves more than 800,000 people in Los Angeles County. We are the nation?s largest public health initiative ? dedicated to helping Los Angeles County residents obtain health care coverage for their families from providers who understand and respect them. When you join our organization, you?re not just building a career; you?re helping care for the communities around you.

 

The Compliance Specialist will review, evaluate and promote compliance issues involving contractual, regulatory and legislative requirements related to the Medi-Cal, Healthy Families, Healthy Kids, and Cal Kids product lines. The position will ensure that consistently high levels of compliance with all regulatory requirements is maintained by serving as a resource for the development, implementation and oversight of all compliance activities for these lines of business; as the subject matter expert for any non-compliance issues, and as a liaison within the Regulatory Affairs and Compliance Department, at the Internal Compliance Committee, and to senior management as appropriate. Finally, this position will ensure that all potential risk issues identifed will be investigated, managed, reported and resolved as appropriate.

 

Qualifications:


Education/Training:  Bachelor's Degree


Experience:

-- 5 years claims adjudication or medical records coding and abstracting experience in a managed care environment, preferably with a health plan;

-- 2-3 years experience dealing with compliance and regulatory issues;

-- demonstrated ability to trend and analyze data and present results effectively;

-- 2-3 years experience conducting in-house training;

-- demonstrated presentation skills;

-- excellent written and verbal communication skills;

-- experience serving liaison between an organization and business partners and regulatory agencies;

-- consultative style with an ability to interact professionally with staff and external customers at all levels; -- successful track record improving regulatory compliance;

-- demonstrated ability to manage multiple projects in a fast-paced environment.

 

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L.A. Care is committed to employee training and development, with a special emphasis on quality improvement.  Help promote health and prevent disease among the vulnerable populations within the communities of Los Angeles County.

For consideration, apply on-line.  Please include salary history and requirement.

 

A great working environment and an exceptional, more than competitive benefits package are the icing on the cake!