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Compliance Consultant Iv

4 months ago

Pasadena, United States Kaiser Permanente Full time

The **Compliance Consultant IV **position will support the **Risk Management, Audit Readiness and Mental Health Parity team**. This role is responsible for intake and implementation of new laws and regulations for Kaiser Permanente National Provider Contracting and Strategy. This includes partnering with external contracted networks and internal stakeholders across markets and departments to ensure compliance.

They will also have accountability for managing delegation oversight requirements for national contracts, conduct audits, address gaps, complete corrective actions, monitor contracts for compliance, implementing process/ controls to manage oversight of contracts, and writing national policies and desktop level procedures.

**Job Summary**:
This individual contributor is primarily responsible for conducting company compliance activities in collaboration with internal and external stakeholders. Responsibilities include developing compliance reports, conducting compliance investigations, coordinating implementation of compliance efforts, and assisting with regulatory compliance through monitoring regulatory changes. This individual contributor also assists with and supports management of projects including assisting in development and coordination of plans and coordinating with stakeholders.

**Essential Responsibilities**:

- Practices self-development and promotes learning in others by proactively providing information, resources, advice, and expertise with coworkers and customers; building relationships with cross-functional stakeholders; influencing others through technical explanations and examples; adapting to competing demands and new responsibilities; listening and responding to, seeking, and addressing performance feedback; providing feedback to others; creating and executing plans to capitalize on strengths and develop weaknesses; supporting team collaboration; and adapting to and learning from change, difficulties, and feedback.
- Develops compliance reports by evaluating and summarizing compliance data, audit information, and potential risks and remedies; reporting to management on key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations); and developing draft presentations to convey key findings.
- Conducts compliance investigations by collecting and analyzing quantitative and qualitative data; conducting interviews as appropriate; researching key business issues; identifying potential action steps; and providing input for the creation of corrective action plans for substantiated allegations.
- Assists with and supports the management of projects or compliance components of larger cross-functional projects by coordinating stakeholder contacts; recommending team resources based on project needs and team member strengths; assisting in the development, analysis, and management of project plans; and coordinating project schedules and resource forecasts.
- Assists with ensuring regulatory compliance by monitoring regulatory changes; conducting analysis on regulatory impacts; and supporting the implementation of designated changes.
- Coordinates the implementation of compliance efforts by identifying compliance requirements; assessing the current state of compliance to identify gaps and corrective actions; creating or revising moderately complex compliance standards, policies and procedures, and training; and monitoring ongoing compliance adherence.

**Minimum Qualifications**:

- Bachelors degree in Health Care Administration, Clinical, Law, Public Health, Business or related field and Minimum six (6) years experience in compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information security, or insurance/health plan governance or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.

**Additional Requirements**:

- N/A

PrimaryLocation : California,Pasadena,Green Street Parking

HoursPerWeek : 40

Shift : Day

Workdays : Mon, Tue, Wed, Thu, Fri

WorkingHoursStart : 08:00 AM

WorkingHoursEnd : 05:00 PM

Job Schedule : Full-time

Job Type : Standard

Employee Status : Regular

Employee Group/Union Affiliation : NUE-PO-01|NUE|Non Union Employee

Job Level : Individual Contributor

Job Category : Compliance, Privacy & Regulatory

Department : Empire Corporate Plaza - NCA Ongoing Operating Exp - 0315

Travel : Yes, 5 % of the Time