Compliance Analyst
3 weeks ago
People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.
Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.
Our Mission: To deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.
Our Vision: To deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome.
Check below to see if you have what is needed for this opportunity, and if so, make an application asap.
JOB SUMMARY: Will coordinate the compliance oversight activities for Imperial and with first tier, downstream and related entities (FDRs) as necessary to meet the contractual oversight regulatory requirements for the prevention, detection and correction of Fraud, Waste and Abuse (FWA) and Medicare program non-compliance as established by the Centers for Medicare and Medicaid Services (CMS).
ESSENTIAL JOB FUNCTIONS:
1. Responsible for supporting the implementation of the seven elements of a compliance program and FDR oversight.
2. Perform audits of operational areas and FDRs (desk or off-site) in accordance with annual workplan or ad-hoc audits to determine compliance with CMS operational and Compliance Program requirements, including validation of data and internal controls.
3. Perform and assess the effectiveness of regulatory compliance training and education activities applicable to Medicare Advantage and other regulatory requirements.
4. Responsible for the issuance and management of compliance actions due to non-compliance resulting from reported issues, monitoring, and auditing activities.
5. Review and interpret all regulatory communications applicable to the organization and FDRs and ensure that appropriate action is taken including dissemination to applicable areas and implementation of changes as needed.
6. Coordinate and perform ongoing internal monitoring of activities including tracking compliance and implementing appropriate action as required.
EDUCATION/EXPERIENCE:
· High school graduate or equivalent.
· Bachelor’s degree preferred and/or 3 to 5 years related work experience in a Medicare Advantage Plan
Required 2 years exp of Medicare Regulatory Requirements (Medicare Managed Care Manuals)
· Required 2 years Medicare compliance experience or in lieu, two years working with CMS
government program, including working knowledge of Medicare Advantage Prescription Drug plan organization and structure
· Medicare Audit experience preferred
SKILLS/KNOWLEDGE/ABILITY:
· Strong computer skills including proficiency in word processing, spreadsheet, and database management skills required
· Knowledge of CMS and State regulatory guidelines related to job functionality
· Ability to work independently
· Strong communications and interpersonal skills
· Ability to meet deadlines
· Ability to maintain an appropriate level of confidentiality and privacy
LICENSURE/CERTIFICATE/TRAINING:
Certified in Healthcare Compliance (CHC) preferred
-
Labor Compliance Analyst
3 weeks ago
Pasadena, United States Scott Conner Human Capital Solutions Full timeJOB DESCRIPTION Pacifica Services is seeking a detail-oriented Labor Compliance Analyst, to provide overall support to various publicly funded public works projects, including transportation, water and public facilities. Primary responsibilities include reviewing Certified Payroll Reports and related documents, identifying issues of non-compliance, and...
-
Labor Compliance Analyst
3 weeks ago
Pasadena, United States Pacifica Services Inc Full timeJob Description Job Description JOB DESCRIPTION Pacifica Services is seeking a detail-oriented Labor Compliance Analyst, to provide overall support to various publicly funded public works projects, including transportation, water and public facilities. Primary responsibilities include reviewing Certified Payroll Reports and related documents, identifying...
-
Labor Compliance Analyst
1 month ago
Pasadena, United States Pacifica Services Full timeJob DescriptionJob DescriptionJOB DESCRIPTIONPacifica Services is seeking a detail-oriented Labor Compliance Analyst, to provide overall support to various publicly funded public works projects, including transportation, water and public facilities. Primary responsibilities include reviewing Certified Payroll Reports and related documents, identifying issues...
-
Labor Compliance Analyst
2 weeks ago
Pasadena, United States Pacifica Services Full timeJob DescriptionJob DescriptionJOB DESCRIPTIONPacifica Services is seeking a detail-oriented Labor Compliance Analyst, to provide overall support to various publicly funded public works projects, including transportation, water and public facilities. Primary responsibilities include reviewing Certified Payroll Reports and related documents, identifying issues...
-
Compliance Analyst
4 weeks ago
Pasadena, United States Imperial Management Administrators Services Full timePeople are the most important asset of Imperial , for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever...
-
Compliance Analyst
2 weeks ago
Pasadena, United States Imperial Management Administrators Services Full timePeople are the most important asset of Imperial , for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever...
-
Compliance Analyst
4 weeks ago
Pasadena, United States Imperial Management Administrators Services Full timePeople are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever...
-
Compliance Analyst
4 weeks ago
Pasadena, United States Imperial Management Administrators Services Full timePeople are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever...
-
Compliance Analyst
4 weeks ago
Pasadena, United States Imperial Management Administrators Services Full timePeople are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever...
-
Pasadena, United States Access Pacific Inc. Full timeJob Description Job Description We are currently seeking a Labor Compliance Administrator who is experienced and ready to hit the ground running from day one. The ideal candidate will have a strong background in Public Works projects using State and Federal Prevailing Wage requirements, as well as familiarity with State Apprenticeship requirements. They must...
-
Labor Compliance Analyst
1 month ago
Pasadena, United States Pacifica Services Full time**JOB DESCRIPTION**: Come join a growing team participating on exciting projects through Los Angeles and greater Southern California. **Roles and Responsibilities**: - Work with appropriate agency staff on identifying applicability of state/federal prevailing wage requirements as well as providing state and federal prevailing wage rates for labor...
-
Pasadena, United States Access Pacific Inc Full timeJob DescriptionJob DescriptionWe are currently seeking a Labor Compliance Administrator who is experienced and ready to hit the ground running from day one. The ideal candidate will have a strong background in Public Works projects using State and Federal Prevailing Wage requirements, as well as familiarity with State Apprenticeship requirements. They must...
-
Financial Analyst
4 days ago
Pasadena, United States Kinect Full timeAs a Financial Analyst, you will be responsible for preparing and analyzing financial reports, ensuring accuracy and compliance with industry standards. You will work closely with the finance team to support financial reporting processes and provide insights that drive strategic decision-making. **Key Responsibilities**: - Prepare and analyze financial...
-
Financial Analyst
5 days ago
Pasadena, United States FIVE ACRES - THE BOYS' AND GIRLS' AID SOCIETY OF LOS ANGELES COUNTY Full timeSummary: Responsible for performing and supporting decision support services, budgeting, financial reporting, analytics, cost accounting, forecasting, projections, predictive and fiscal modeling for the Agency. Developing reports, information and provide analysis that supports organizational decision making through high-level analysis, reporting, research...
-
Business Operations Analyst
4 weeks ago
Pasadena, United States Artech Full timeTop Daily Responsibilities: The is a 50% admin support and 50% business analyst role Administration (Calendaring, Expenses, Meeting Set-Up) -Operations (People Management, Enablement, and Development) -Compliance (Training, Business Continuity, Performance Management) -Gathers requirements for reporting business metrics for an organization. -Analyzes...
-
Management Analyst I
1 month ago
Pasadena, United States City of Pasadena Full timeThe City of Pasadena's Transportation Department has an exciting opportunity for an enthusiastic, motivated, detailed-oriented Management Analyst I (Transit Analyst) to have an integral role in our Transit Division and in providing excellent public transportation services to the community and the region. The ideal candidate will be highly adaptable,...
-
BSA Analyst II
2 weeks ago
Pasadena, United States East West Bank Full timeOverview East West Bank is seeking a BSA Analyst II. The BSA Analyst II's primary function is to complete SAR reviews of the bank's high risk customers. We offer flexible Hybrid schedule. Responsibilities Perform research, analysis and investigation of a SAR Filing Document results of SAR file review Escalate potentially suspicious...
-
BSA Analyst II
2 weeks ago
Pasadena, United States East West Bank Full timeOverview East West Bank is seeking a BSA Analyst II. The BSA Analyst II's primary function is to complete SAR reviews of the bank's high risk customers. We offer flexible Hybrid schedule. Responsibilities Perform research, analysis and investigation of a SAR Filing Document results of SAR file review Escalate potentially suspicious...
-
Bsa Analyst Ii
2 weeks ago
Pasadena, United States East West Bank Full timeIntroduction: Since 1973, East West Bank has served as a pathway to success. With over 120 locations across the U.S. and Asia, we are the premier financial bridge between the East and West. Our teams of experienced, multi-cultural professionals help guide businesses and community members on both sides of the Pacific looking to explore new markets and create...
-
Business Operations Analyst
4 weeks ago
Pasadena, United States Alpha Consulting Full timeTop Daily Responsibilities: The is a 50% admin support and 50% business analyst role Administration (Calendaring, Expenses, Meeting Set-Up) -Operations (People Management, Enablement, and Development) -Compliance (Training, Business Continuity, Performance Management) -Gathers requirements for reporting business metrics for an organization. -Analyzes...
