Current jobs related to Compliance Program Manager - French Camp - SAN JOAQUIN COUNTY HEALTH COMMISSION
-
Compliance Program Manager
1 month ago
French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full timeJob Title: Compliance Program ManagerJob Summary:We are seeking a highly skilled Compliance Program Manager to join our team at SAN JOAQUIN COUNTY HEALTH COMMISSION. As a Compliance Program Manager, you will be responsible for maintaining oversight responsibilities of assigned internal and delegated third-party entities and overseeing their performance of...
-
Compliance Director
7 days ago
French Camp, California, United States Health Plan San Joaquin Full timeJob Title: Director, ComplianceThe Director, Compliance will be responsible for developing and overseeing the implementation of strategic and operational objectives and plans according to best practices, internal and external requirements, with a focus on Centers for Medicare & Medicaid Services (CMS), and in support of organizational strategy.Key...
-
Compliance Analyst, Senior
1 month ago
French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full timeJob SummaryWe are seeking a highly skilled and experienced Senior Compliance Analyst to join our team at San Joaquin County Health Commission. The ideal candidate will have a strong background in compliance and regulatory affairs, with a focus on healthcare and managed care operations.Key ResponsibilitiesConduct thorough reviews and analysis of...
-
Assistant Program Director
1 month ago
French Camp, California, United States Turning Point Community Programs Full timeJob SummaryWe are seeking a highly skilled and experienced Assistant Program Director to join our team at Turning Point Community Programs. The successful candidate will be responsible for supervising Personal Service Coordinators and assisting the Program Director in the functioning of the program.Key ResponsibilitiesSupervise and support Personal Service...
-
Construction Manager
2 weeks ago
French Camp, California, United States Vanir Construction Management Full timeJob Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to join our team. As a Construction Manager, you will be responsible for overseeing the construction process of a solar/carport design/build project in San Joaquin County, CA.Key Responsibilities:Coordinate design and construction process with the...
-
Construction Manager
2 weeks ago
French Camp, California, United States Vanir Construction Management Full timeJob Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to join our team. As a Construction Manager, you will be responsible for overseeing the construction process of a solar/carport design/build project in San Joaquin County, CA.Key Responsibilities:Coordinate design and construction process during...
-
Construction Manager
2 weeks ago
French Camp, Mississippi, United States Vanir Construction Management Full timeJob Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to lead our solar/carport design/build project in San Joaquin County, CA.Job Summary:The Construction Manager will be responsible for providing general on-site construction management of the project, coordinating with the design-builder, and...
-
Clinical Case Manager RN
3 weeks ago
French Camp, Mississippi, United States Health Plan San Joaquin Full timeJob Title: Clinical Case Manager RNWe are seeking a highly skilled and compassionate Clinical Case Manager RN to join our team at Health Plan San Joaquin. As a key member of our healthcare team, you will play a vital role in ensuring our members receive the highest quality care and support.Job Summary:The Clinical Case Manager RN will be responsible for...
-
Construction Manager
2 weeks ago
French Camp, Mississippi, United States Vanir Construction Management Full timeJob Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to lead our solar carport design/build project in San Joaquin County, CA.Job Summary:The Construction Manager will provide general on-site construction management of the project, working closely with the design-builder to coordinate the design and...
-
Shift Operations Manager
2 weeks ago
French Camp, California, United States Turning Point Community Programs Full timeJob Title: Shift Operations ManagerJob Summary:We are seeking a highly skilled and experienced Shift Operations Manager to join our team at Turning Point Community Programs. The successful candidate will be responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key Responsibilities:Provide leadership and direction for...
-
Accounting Manager
7 days ago
French Camp, California, United States Health Plan San Joaquin Full timeAccounting Manager Job DescriptionWe are seeking an experienced Accounting Manager to join our team at Health Plan San Joaquin. The successful candidate will be responsible for planning and directing accounting activities, ensuring the accuracy of financial records, and meeting reporting deadlines.Key Responsibilities:Establish and monitor financial systems,...
-
Shift Operations Manager
1 month ago
French Camp, California, United States Turning Point Community Programs Full timeJob SummaryWe are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. This is an at-will leadership position within a program, responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key ResponsibilitiesProvide leadership and direction for clients/staff in the...
-
Deputy Chief Medical Officer
2 weeks ago
French Camp, California, United States Health Plan of San Joaquin Full timeJob SummaryWe are seeking a highly skilled and experienced Deputy Chief Medical Officer to join our team at Health Plan of San Joaquin. As a key member of our leadership team, you will be responsible for leading efforts to provide innovative solutions that support quality healthcare, promote personal accountability for health and wellness, and offer superior...
-
Shift Operations Manager
1 month ago
French Camp, California, United States Turning Point Community Programs Full timeJob Title: Shift SupervisorJob Summary:We are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. As a Shift Supervisor, you will be responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key Responsibilities:Provide leadership and direction for clients/staff in...
-
Deputy Chief Medical Officer
2 weeks ago
French Camp, Mississippi, United States Health Plan San Joaquin Full timeJob SummaryWe are seeking a highly skilled and experienced Deputy Chief Medical Officer to join our team at Health Plan San Joaquin. As a key member of our leadership team, you will be responsible for leading efforts to provide innovative solutions that support quality healthcare, promote personal accountability for health and wellness, and offer superior...
-
Construction Manager Solar Carport Project
4 weeks ago
French Camp, California, United States Vanir Construction Management Full timeJob Title: Construction Manager Solar Carport ProjectVanir Construction Management is seeking a highly skilled Construction Manager to lead our solar carport design/build project in San Joaquin County, CA.Job Summary:The Construction Manager will provide general on-site construction management of the project, working closely with the design-builder to...
-
Shift Operations Manager
1 month ago
French Camp, California, United States Turning Point Community Programs Full timeJob SummaryWe are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. This is a leadership position that requires strong organizational and communication skills, as well as the ability to work effectively in a fast-paced environment.Key ResponsibilitiesProvide leadership and direction to clients and...
-
Deputy Chief Medical Officer
4 weeks ago
French Camp, California, United States Health Plan of San Joaquin Full timeJob SummaryWe are seeking a highly experienced and skilled Deputy Chief Medical Officer to join our team at Health Plan of San Joaquin. As a key member of our leadership team, you will be responsible for leading efforts to provide innovative solutions that support quality healthcare, promote personal accountability for health and wellness, and offer superior...
-
Concurrent Review Nurse
3 weeks ago
French Camp, Mississippi, United States Health Plan San Joaquin Full timeJob SummaryWe are seeking a skilled Concurrent Review Nurse to join our team at Health Plan San Joaquin. As a key member of our Long-Term Care team, you will play a critical role in ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesConduct concurrent reviews of inpatient activities to ensure compliance with HPSJ,...
-
Concurrent Review Nurse Specialist
2 weeks ago
French Camp, Mississippi, United States Health Plan San Joaquin Full timeJob SummaryWe are seeking a skilled Concurrent Review Nurse to join our team at Health Plan San Joaquin. As a key member of our Long-Term Care team, you will be responsible for conducting concurrent reviews of inpatient activities, ensuring that member care is rendered at the most appropriate level, and collaborating with providers to resolve care issues.Key...
Compliance Program Manager
2 months ago
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
Join our team as our new Compliance Program Manager (Audit & Oversight) with Health Plan of San Joaquin
Must reside in California – Eligible for remote work; hybrid.
What You Will Be Doing:
Under general supervision, maintains oversight responsibilities of assigned third-party entities and oversees their performance activities to ensure compliance with the contractual Service Level Agreements and federal/state laws, regulations and program standards. Work is varied and moderately complex and requires a moderate degree of discretion and independent judgement.
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Supervises
None
Essential Functions:
- Serve as HPSJ’s one point of contact and build collaborative working relationship with the assigned third-party entities in matters related to their contractual and regulatory obligations.
- Monitors and tracks service levels/performance for the assigned third-party entities.
- Compiles dashboards and communicate results timely with internal and external stakeholders.
- Reviews and analyzes reports to identify areas of risk; escalates risk areas to Director and other internal stakeholders for further actions.
- Collaborates with HPSJ’s Business Owners and Third-Party entities to remediate deficiencies found and to ensure the lack of performance is remediated timely.
- Escalates prolonged or non-responsive performance issues to Compliance, Audit & Oversight or Provider Contracting for further actions.
- Participates in Corrective Action Plan (CAP) processes to ensure the final resolution is completed to HPSJ’s satisfaction.
- Collaborates with Compliance and provide webinar training or written communication on applicable regulatory changes.
- Leads or participates in regular or ad hoc Joint Operations Meetings (JOM) with the assigned third-party entities regularly.
- Conducts relevant training and education, as needed.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
- In-depth knowledge of health plan functions and interactions as they relate to third-party entities and their contractual relationships with HPSJ.
- In-depth knowledge of contracting regulations and best practices
- Knowledge of and ability to effectively apply the principles and best practices of project management, including but not limited to: project lifecycle, scope definition and management, planning and scheduling, monitoring, communication cycles, project team and risk management.
- Builds partnerships and works collaboratively with others to meet shared objectives.
- Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Strong oral and written communication skills, with the ability to communicate professionally to diverse individuals and groups inside and outside of HPSJ.
- Strong presentation skills, including but not limited to the ability to tailor presentations to a specific audience, and identify key messages.
- Strong problem solving and analytical skills, with ability to determine key issues, develop effective action plans, including escalation, and implement to successful conclusion.
- Strong leadership skills, including but not limited to the ability to influence without authority and motivate others; ability to hold third parties accountable for performance.
- Produces work that is accurate and complete.
- Produces the appropriate amount of work.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Ability to work independently and as part of a team.
- Ability to read, understand and apply complex written guidelines, instructions and other materials.
- Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
- Strong knowledge of change management theory and ability to implement and manage effectively.
- Commitment to and ability to facilitate the adoption of HPSJ’s strategy, vision, mission and values.
- Proven arithmetic skills.
- Advanced skills in Word, Excel, PowerPoint, and Visio.
- Proficient with MS Excel, Power BI or other dashboarding tools.
- Intermediate skills in SharePoint.
- Ability to speak, be understood, read and write in English.
- Ability to handle confidential information with appropriate discretion.
What You Have:
Education and Experience
Required
- Bachelor’s Degree; and
- At least two-years of experience as a program or project manager in a healthcare environment; and
- Experience in leading or participating in vendor, customer or provider relationship management; or
- Equivalent combination of education and experience.
Preferred
- Master’s Degree in Business Administration, Public Health, Health Administration or related field.
- PMP and/or LEAN/Six Sigma certification
- Experience with Medi-Cal, Medicare D-SNP, DMHC and DHCS regulations and contract requirements.
- Experience with managed care operations
- Experience in managing vendor compliance and oversight of health-care related delegation activities.
What You Will Get:
HPSJ Perks:
- Competitive salary
- Robust and affordable health/dental/vision with choices in providers
- Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
- CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
- Two flexible spending accounts (FSAs)
- Employer-Paid Term Life and AD&D Insurance
- Employer-Paid Disability Insurance
- Employer-Paid Life Assistance Program
- Health Advocacy
- Supplemental medical, legal, identity theft protection
- Access to exclusive discount mall
- Education and training reimbursement in addition to employer-paid elective learning courses.
- A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
- A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
- Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.
HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.
Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.