Compliance Analyst

1 week ago

San Jose, United States Santa Clara Family Health Plan Full time
FLSA Status: Exempt
Department: Compliance
Reports To: Manager, Compliance (Medi-Cal/Medicare)

Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521
GENERAL DESCRIPTION OF POSITION

The Compliance Analyst researches, plans, implements, and monitors a broad portfolio of compliance programs and initiatives to enable organizational compliance with all applicable Federal, state, and local regulations/laws. On an on-going basis, researches and interprets regulations and laws to establish compliance standards, and may develop and/or deliver training and/or communications relative to new standards. May be responsible for project management relative to new compliance initiatives, products, or annual processes
ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.
  1. Implement, support and enforce SCFHP's Privacy Program; assist in updates and revisions to the Privacy Program as needed or required by law to ensure SCFHP's compliance with state, federal and international privacy laws; implement, support, and enforce best practices to protect the privacy of members' protected health information (PHI).
  2. Build strong relationships and collaborate with business units to promote the Privacy Program and encourage privacy compliance at all levels of the organization
  3. Assist as requested in the timely creation, review, revision and updates to privacy policies, desk level procedures, resource guides, job aides and other educational tools
  4. Provide guidance and instruction to workforce members on privacy policies and procedures, privacy-related questions, and subject matter expertise as needed for each unique, individual situation.
  5. Act as a liaison with regulatory enforcement agencies; cooperate and participate as required by technical assistance letters, investigations, compliance reviews, audits and other reviews made by regulatory agencies, including CMS, OCR, DMHC, and DHCS.
  6. Provides project management, coordination, and analytical support for compliance projects. Provides consultation on internal and external requirements. Evaluates regulatory requirements and potential operational impacts.
  7. Assists in the identification of compliance program needs, and develops strategies, plans, and documentation for programs and related initiatives.
  8. Supports the Manager, Compliance (Medi-Cal/Medicare) by designing, documenting and implementing process improvement initiatives within the department.
  9. Supports and when directed, leads the Compliance Work Group and other cross-functional work groups.
  10. Assists in leading the development and maintenance of health plan FWA program capabilities and offerings.
  11. Supports compliance audits, risk assessments and ongoing compliance monitoring activities, including the coordination of data requests.
  12. Assists in identifying, developing, implementing and maintaining compliance policies and procedures and department documentation.
  13. Preparing and submitting timely and accurate regulatory filings (DMHC, DHCS, provider network contracts, licensing renewals, etc.), regulatory reports, and compliance attestations.
  14. Perform other related duties as required or assigned.
REQUIREMENTS - Required (R) Desired (D)

The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
  1. Bachelor's Degree in Business, Healthcare Administration or a related field or equivalent experience, training or coursework. (R)
  2. Minimum 3 years progressively responsible compliance experience in a healthcare or managed care environment. A Master's Degree may be substituted for one year of required experience. (R)
  3. Knowledge of health care compliance policies, practices and systems. (R)
  4. Ability to analyze and interpret data to identify trends. (R)
  5. Ability to maintain detailed and accurate records; follow oral and written directions; prepare written agendas, transcribe minutes, and develop reports. (R)
  6. Ability to conduct all necessary research, root analysis and trends to accurately identify complex issues. (R)
  7. Ability to consistently meet compliance accuracy and timeline requirements according to regulatory requirements. (R)
  8. The ability to form positive, professional relationships with regulators, providers, and stakeholders. (R)
  9. Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, Access, and PowerPoint. (R)
  10. Ability to use keyboard with moderate speed and a high level of accuracy. (R)
  11. Excellent communication skills including the ability to express oneself clearly and concisely when interacting with SCFHP internal and external stakeholders over the telephone, in person or in writing and the ability to remain calm and de-escalate tense situations. (R)
  12. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
  13. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
  14. Ability to maintain confidentiality. (R)
  15. Ability to comply with all SCFHP policies and procedures. (R)
  16. Ability to perform the job safely and with respect to others, to property and to individual safety. (R)
WORKING CONDITIONS

Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
PHYSICAL REQUIREMENTS

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:
  1. Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
  2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
  3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
  4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
  5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
  6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)
ENVIRONMENTAL CONDITIONS

General office conditions. May be exposed to moderate noise levels.

  • Compliance Analyst

    2 days ago

    San Jose, United States Zenex Partners Full time

    Compliance Analyst Location:- San Jose, CA (Hybrid Schedule) Duration:- 6+ Months Pay rate:- $35 - $45/hr W2. Responsibilities of Compliance Analyst Analyze new business initiatives and products to identify potential privacy risks. Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training, where appropriate, due to changes...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Zenex Partners Full time

    Job Description Job Description Compliance Analyst Location:- San Jose, CA (Hybrid Schedule) Duration:- 6+ Months Pay rate:- $35 - $45/hr W2. Responsibilities of Compliance Analyst Analyze new business initiatives and products to identify potential privacy risks. Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training,...

  • Compliance Analyst

    7 days ago

    San Jose, United States Zenex Partners Full time

    Compliance Analyst Location:- San Jose, CA (Hybrid Schedule) Duration:- 6+ Months Pay rate:- $35 - $45/hr W2. Responsibilities of Compliance Analyst Analyze new business initiatives and products to identify potential privacy risks. Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training, where appropriate, due to...

  • Compliance Analyst

    3 weeks ago

    San Jose, United States Zenex Partners Full time

    Job DescriptionJob DescriptionCompliance AnalystLocation:- San Jose, CA (Hybrid Schedule)Duration:- 6+ MonthsPay rate:- $35 - $45/hr W2.Responsibilities of Compliance AnalystAnalyze new business initiatives and products to identify potential privacy risks.Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training, where...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Zenex Partners Full time

    Compliance AnalystLocation:- San Jose, CA (Hybrid Schedule)Duration:- 6+ MonthsPay rate:- $35 - $45/hr W2.Responsibilities of Compliance AnalystAnalyze new business initiatives and products to identify potential privacy risks.Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training, where appropriate, due to changes in...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Zenex Partners Full time

    Compliance AnalystLocation:- San Jose, CA (Hybrid Schedule)Duration:- 6+ MonthsPay rate:- $35 - $45/hr W2.Responsibilities of Compliance AnalystAnalyze new business initiatives and products to identify potential privacy risks.Develop, amend (as needed) and implement policies, procedures, manuals, systems, and training, where appropriate, due to changes in...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Ursus Inc Full time

    JOB TITLE: Compliance Analyst LOCATION: San Jose, CA DURATION: 6 months PAY RANGE: $35- $45/hr COMPANY: Our client, a multinational electronics company is recruiting for a Compliance Analyst. If you meet the qualifications listed, please Apply Now! Description: - Analyze new business initiatives and products to identify potential privacy risks. - Develop,...

  • Compliance Analyst

    1 week ago

    San Jose, United States Ursus Inc Full time

    JOB TITLE: Compliance Analyst LOCATION: San Jose, CA - HYBRID DURATION: 6 months PAY RANGE: $35- $45/hr COMPANY: Our client, a multinational electronics company is recruiting for a Compliance Analyst. If you meet the qualifications listed, please Apply Now! Description: - Analyze new business initiatives and products to identify potential privacy risks....

  • Compliance Analyst

    1 week ago

    San Jose, California, United States Santa Clara Family Health Plan Full time

    Join Our Team as a Compliance Analyst at SCFHP!If you're passionate about ensuring organizational compliance with regulations and laws, this might be the perfect job for you. As a Compliance Analyst at SCFHP, you'll play a critical role in researching, planning, implementing, and monitoring compliance programs. Here's a breakdown of what you'll be...

  • Compliance Analyst

    6 days ago

    San Jose, United States InterSources Full time

    Title: Compliance Analyst Location: ustin, TX or Sunnyvale, CA Duration: Long term contract Skills: Information management & Security, Unix Shell scripting, Networking & communication protocols, Python. RESPONSIBILITIES: The primary responsibility of this position is using tools, is to analyze the effectiveness of firewall rules, router configurations and...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Santa Clara Family Health Plan Full time

    **About Us**: Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) health care plans. **About the...

  • T&E Compliance Analyst

    1 week ago

    San Jose, United States F. Hoffmann-La Roche AG Full time

    Roche fosters diversity, equity and inclusion, representing the communities we serve. When dealing with healthcare on a global scale, diversity is an essential ingredient to success. We believe that inclusion is key to understanding peoples varied h Compliance Analyst, Compliance, Analyst, Healthcare, Solutions, Operations, Technology

  • Compliance Analyst

    1 week ago

    San Jose, United States InterSources Full time

    Title: Compliance Analyst Location: ustin, TX or Sunnyvale, CA Duration: Long term contractSkills: Information management & Security, Unix Shell scripting, Networking & communication protocols, Python. RESPONSIBILITIES: The primary responsibility of this position is using tools, is to analyze the effectiveness of firewall rules, router configurations and...

  • Compliance Analyst

    2 weeks ago

    San Jose, United States Santaclara Family Health Plan Full time

    FLSA Status: Exempt Department: Compliance Reports To: Manager, Compliance (Medi-Cal/Medicare) Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 GENERAL DESCRIPTION OF POSITION The Compliance Analyst researches, plans, implements, and monitors a broad portfolio of compliance...

  • Business Resiliency Compliance Analyst

    2 months ago

    San Jose, California, United States GDH Full time

    GDH Consulting is looking for a Business Resiliency Compliance Analyst to work remotely.Description: Our client is seeking a qualified business continuity professional to function as a Corporate Security – Business Resiliency Program Analyst in RTP, North Carolina. The hours of work would typically be Monday to Friday however this would vary based on real...

  • Business Resiliency Compliance Analyst

    4 weeks ago

    San Jose, California, United States GDH Full time

    GDH Consulting is looking for a Business Resiliency Compliance Analyst to work remotely.Description: Our client is seeking a qualified business continuity professional to function as a Corporate Security – Business Resiliency Program Analyst in RTP, North Carolina. The hours of work would typically be Monday to Friday however this would vary based on real...

  • Compliance Analyst

    1 month ago

    San Antonio, United States City of San Antonio Texas Full time

    Under general supervision, assists in planning, organizing, directing, investigating and assessing contract compliance. Provides assistance in performing project steps and procedures to establish and maintain contract and/or grant compliance by both Compliance Analyst, Compliance, Analyst, Accounting, Monitoring, Technology

  • Global Regulatory Compliance Data Analyst

    1 week ago

    San Jose, California, United States MILLENNIUMSOFT Full time

    Job Title: Global Regulatory Compliance Data Analyst (Mathematics Knowledge) Location: San Jose, CA Duration: 12+ Months Client: Medical Device Company Job Category: Research & Development Employment Type: Contract on W2 (Need US Citizens Or GC Holders Only) No H1Bs Work hours: 40hr/ week Remote for now, but will be expected onsite once site opens. Must be...

  • Compliance Analyst

    2 months ago

    San Ramon, United States psg Full time

    Seeking a Compliance Analyst to plan, direct, and coordinate operations of to ensure compliance with ethical or regulatory standards in Banking. Job Responsibilities: - Candidate must be local to San Ramon CA will be a hybrid work model - Computer Compliance, Analyst, Fraud, Staffing, Technology, Management, Regulatory

  • Compliance Analyst

    2 months ago

    San Francisco, United States Robert Walters Full time

    Compliance Analyst Our client, an established and well-performing investment manager in San Francsico CA, is seeking a Compliance Analyst to join their team. As a Compliance Analyst, you will play a crucial role in maintaining the integrity of our client's operations. Your responsibilities will span across various aspects of compliance, legal, and...