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Health Care Compliance Coordinator

1 month ago

Phoenix, United States Tangocare Full time

Brief Description This position requires the candidate to be based in the Arizona area ONLY. The Compliance Coordinator serves as a departmental support person for Compliance functions. Essential Functions Assists in the monitoring of business and operations activities for compliance with internal audit processes and external health plan and regulatory rules and regulations. Uploads monthly, quarterly, and annual reports to secure sites while maintaining high accuracy, timeliness, and security of the data. Performs detailed examinations of audit documentation. Ability to communicate, interact, and work well with others. Coordinates deliverables for internal/external audits, CAPs (Corrective Action Plans), Compliance, and PI/QM (Performance Improvement & Quality Management) projects. Coordinates annual policy reviews, makes policy revisions as directed, keeps policies organized, revised, and updated in compliance with regulatory and specific contract requirements. Conducts research, updates, and assists in tracking of licenses specific to State guidelines and includes clinician licenses. Assists and stays up to date with any regulatory actions relevant to healthcare. Compiles data and can put it in pivot tables within Excel. Works well under deadlines and can meet required timeframes. Other Duties And Responsibilities As requested by supervisor. Knowledge And Experience Healthcare industry experience, compliance, and knowledge of medical terminology required. Knowledge of health plan regulatory reports such as ODAG, NCQA/URAC, ICD-10 coding, medical terminology, and EMR (Electronic Medical Records) Systems required. Previous internal audit experience preferred. Proficiency in Microsoft Office Applications including Excel, PowerPoint, Adobe, and Word. Must be ethical and trustworthy. Excellent writing skills. Knowledge of HIPAA regulations and guidelines. Must be organized, detail-oriented, and able to multitask. Project management skills preferred. Excellent verbal and written communication skills. Critical thinking and problem-solving skills. Experience with licensing, credentialing, and different state agencies' regulatory requirements. Must be able to work in a team environment and independently. Tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship. #J-18808-Ljbffr