Specialist 2 - Health Care Compliance

2 weeks ago

Titusville, United States Pyramid Consulting Full time

Immediate need for a talented Specialist 2 - Health Care Compliance. This is a 24+months contract opportunity with long-term potential and is located in Titusville, NJ (Hybrid). Please review the job description below and contact me ASAP if you are interested.

Job ID:24-51310

Pay Range: $40 - $45/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

  • Drive critical data analysis through regular oversight and monitoring activities using expense data, customer master, and other fee-for-service data with an eye toward automation.
  • Assist HCCOs in providing guidance and oversight on business programs, initiatives, and processes based upon insights and trends identified from monitoring activities.
  • Complete special projects as identified, working across HCC and other business functions.
  • Prepare and present presentations to HCC Officers highlighting monitoring trends and areas of risk.
  • Contribute to Program Management oversight & monitoring efforts by serving as a liaison between HCC Officers, Compliance & Technology Integration (CTI), and Global Assessment and Consulting Services (GACS), reviewing monitoring reports, analyzing for potential issues and trends, conducting, and documenting follow-Client, recommending enhancements, and capturing insights and trends in collaboration with the HCC Officers.
  • Identify and/or implement business efficiencies, technology solutions, process improvements and enhanced reporting capabilities to assist in the implementation of a sustainable HCC program.
  • Assist in coordinating Risk Assessment process for the region and identifying and driving process improvements across the team.
  • Develop and implement metrics, templates, and/or scorecards to support annual risk assessment and quarterly risk reviews.
  • Provide transactional reviews of transfers of value to health care professionals and government officials, perform reviews of material, and engage with business partners to provide guidance on HCC-sensitive topics in alignment with HCC policies/procedures.
  • Partner with HCC leadership and HCCOs to create and deliver targeted HCC communications to the HCC community or business partners.
  • Assist in developing and/or revising training to support HCC program elements. Collaborate with third-party vendor to communicate training needs.
  • Collaborate with HCC Officers to facilitate revisions to HCC policy manual and supporting policy documents as needed .
Key Requirements and Technology Experience:
  • Key Skills:Data Analyst, Bachelors, Healthcare .
  • A minimum of a Bachelors' Degree or equivalent degree .
  • Minimum of 1 year business experience .
  • Excellent English verbal and written communication skills, including formal .
  • Ability to collaborate in a cross-functional team environment.
  • High quality standard with a strong work ethic and professionalism to co-workers and customers.
  • Experience identifying and/or implementing process improvement.
  • Skill analyzing large data sets.
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, 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.

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