Compliance Analyst - Managed Care
Job Details
Experienced
Irvine, CA or Long Beach, CA - Irvine or Long Beach, CA
Full Time
Bachelors Degree
None
Day
Legal
Description

The role of a Compliance Analyst is to ensure LIBERTY’s compliance program meets regulatory and contractual standards for commercial, Exchange, Medicaid, and Medicare lines of business.  The successful individual must demonstrate integrity, credibility, strong interpersonal skills, and a command of regulatory requirements impacting government managed healthcare.  Additionally, this role requires the ability to handle sensitive matters with the utmost discretion. 

 

Essential Duties:

  • Coordinates preparation and submission of timely and accurate regulatory filings involving multi-department or cross-functional teams of subject matter experts, managing deliverables from the design process through completion. 
  • Maintains LIBERTY’s Compliance Central system, including coordinating all triage notifications and requests, routing to and working with business owners ensuring high quality timely deliverables.
  • Coordinates all aspects of client and regulatory audit preparation and the development of reports/tools to monitor and track implementation and completion of corrective action plans.
  • Communicates and collaborates with business areas to analyze regulatory guidelines and deliver the appropriate artifacts as needed.
  • Maintains a compliance dashboard, weekly compliance status summaries, compliance status tracking tools, etc. 
  • Leads large, complex projects to achieve a variety of compliance objectives.
  • Interprets and analyzes state and federal regulatory guidance.
  • Works with operational leaders within the business to provide recommendations on opportunities for process improvements.

Distinguishing Characteristics

The Analyst performs moderate to complex tasks with minimal supervision, and supports the most difficult and complex assignments within the job function.  Leads cross-functional compliance initiatives.  Typically requires 4+ years of direct regulatory compliance and government managed healthcare experience, and relevant industry certifications.

Qualifications

Education and/or Experience:

  • A minimum of a BA degree and relevant industry certifications
  • 2-5+ years of progressive regulatory compliance and oversight experience
  • Direct experience in government managed or regulated healthcare (Medicaid / Medicare)
  • Experience in compiling, coordinating, analyzing, and organizing regulatory requirement data
  • Experience with compliance audits and assessments
  • Heavy writing / composition experience

Specific Skills/Knowledge:

  • Excellent critical thinking and problem-solving skills
  • Strong to expert computer skills – specifically, MS Office (Excel, Word, PowerPoint) and SharePoint
  • Effective oral and written communication skills at all organizational levels
  • Ability to manage multiple tasks and deliverables in a fast-paced environment

Environment and/or Physical Factors:

Work is generally performed within an office environment, with standard office equipment available. Sedentary work involves extensive sitting, typing, and close-range vision most of the time.

 

Sponsorship and Relocation Specifications:

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.

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