Current jobs related to Compliance Operations Manager - French Camp, California - SAN JOAQUIN COUNTY HEALTH COMMISSION

  • Compliance Program Manager

    1 month ago

    French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    Job Title: Compliance Program ManagerJob Summary:We are seeking a highly skilled Compliance Program Manager to join our team at SAN JOAQUIN COUNTY HEALTH COMMISSION. As a Compliance Program Manager, you will be responsible for maintaining oversight responsibilities of assigned internal and delegated third-party entities and overseeing their performance of...

  • Compliance Director

    3 days ago

    French Camp, California, United States Health Plan San Joaquin Full time

    Job Title: Director, ComplianceThe Director, Compliance will be responsible for developing and overseeing the implementation of strategic and operational objectives and plans according to best practices, internal and external requirements, with a focus on Centers for Medicare & Medicaid Services (CMS), and in support of organizational strategy.Key...

  • Compliance Analyst, Senior

    4 weeks ago

    French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Compliance Analyst to join our team at San Joaquin County Health Commission. The ideal candidate will have a strong background in compliance and regulatory affairs, with a focus on healthcare and managed care operations.Key ResponsibilitiesConduct thorough reviews and analysis of...

  • Shift Operations Manager

    1 week ago

    French Camp, California, United States Turning Point Community Programs Full time

    Job Title: Shift Operations ManagerJob Summary:We are seeking a highly skilled and experienced Shift Operations Manager to join our team at Turning Point Community Programs. The successful candidate will be responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key Responsibilities:Provide leadership and direction for...

  • Shift Operations Manager

    4 weeks ago

    French Camp, California, United States Turning Point Community Programs Full time

    Job Title: Shift SupervisorJob Summary:We are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. As a Shift Supervisor, you will be responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key Responsibilities:Provide leadership and direction for clients/staff in...

  • Environmental Health and Safety Manager

    4 weeks ago

    French Camp, California, United States The Judge Group Full time

    Environmental Health and Safety ManagerAre you passionate about creating a safer workplace? Do you thrive on ensuring compliance with environmental regulations? We have an exciting opportunity for you!Our client, a well-known Fortune 500 Food and Beverage Manufacturer, is renowned for its exceptional workplace culture, a factor that has made it a beloved...

  • Shift Operations Manager

    4 weeks ago

    French Camp, California, United States Turning Point Community Programs Full time

    Job SummaryWe are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. This is an at-will leadership position within a program, responsible for overseeing shift operations, scheduling, and assisting the Program Director.Key ResponsibilitiesProvide leadership and direction for clients/staff in the...

  • Shift Operations Manager

    1 month ago

    French Camp, California, United States Turning Point Community Programs Full time

    Job SummaryWe are seeking a highly skilled and experienced Shift Supervisor to join our team at Turning Point Community Programs. This is a leadership position that requires strong organizational and communication skills, as well as the ability to work effectively in a fast-paced environment.Key ResponsibilitiesProvide leadership and direction to clients and...

  • Construction Manager

    2 weeks ago

    French Camp, California, United States Vanir Construction Management Full time

    Job Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to join our team. As a Construction Manager, you will be responsible for overseeing the construction process of a solar/carport design/build project in San Joaquin County, CA.Key Responsibilities:Coordinate design and construction process with the...

  • Construction Manager

    2 weeks ago

    French Camp, California, United States Vanir Construction Management Full time

    Job Title: Construction ManagerVanir Construction Management is seeking a highly skilled Construction Manager to join our team. As a Construction Manager, you will be responsible for overseeing the construction process of a solar/carport design/build project in San Joaquin County, CA.Key Responsibilities:Coordinate design and construction process during...

  • Shift Operations Manager

    1 week ago

    French Camp, California, United States Turning Point Community Programs Full time

    pbJobDescription/b/ppThisleadershippositionisresponsibleforoverseeingshiftoperations,scheduling,andassistingtheProgramDirector.Theidealcandidatewillhaveastrongbackgroundinmentalhealthservicesandexperienceinleadershiproles./ppbKeyResponsibilities/b/pulliProvideleadershipanddirectionforclients/staffintheabsenceoftheTeamLeader./liliReviewandtrackstaffprogressno...

  • Accounting Manager

    3 days ago

    French Camp, California, United States Health Plan San Joaquin Full time

    Accounting Manager Job DescriptionWe are seeking an experienced Accounting Manager to join our team at Health Plan San Joaquin. The successful candidate will be responsible for planning and directing accounting activities, ensuring the accuracy of financial records, and meeting reporting deadlines.Key Responsibilities:Establish and monitor financial systems,...

  • Deputy Chief Medical Officer

    4 weeks ago

    French Camp, California, United States Health Plan of San Joaquin Full time

    Job SummaryWe are seeking a highly experienced and skilled Deputy Chief Medical Officer to join our team at Health Plan of San Joaquin. As a key member of our leadership team, you will be responsible for leading efforts to provide innovative solutions that support quality healthcare, promote personal accountability for health and wellness, and offer superior...

  • Environmental Services Technician

    1 month ago

    French Camp, California, United States Clean Harbors Full time

    Job SummaryClean Harbors is seeking a highly skilled Field Services Technician I to join our team in Stockton, CA. As a key member of our safety-conscious team, you will be responsible for performing tasks associated with hazardous waste clean-up, site-remediation, equipment decontamination, and handling of hazardous materials.Key ResponsibilitiesEnsure...

  • Deputy Chief Medical Officer

    2 weeks ago

    French Camp, California, United States Health Plan of San Joaquin Full time

    Job SummaryWe are seeking a highly skilled and experienced Deputy Chief Medical Officer to join our team at Health Plan of San Joaquin. As a key member of our leadership team, you will be responsible for leading efforts to provide innovative solutions that support quality healthcare, promote personal accountability for health and wellness, and offer superior...

  • Sports Medicine Physician

    2 months ago

    French Camp, California, United States Department of Veteran Affairs Full time

    Department of Veteran Affairs is dedicated to providing an extensive range of health services, including medical, surgical, rehabilitative, and mental health care to our esteemed veterans. Position Overview: The Sports Medicine Physician role is situated in Stockton, CA, and is a vital component of the Interdisciplinary Amputee Clinic Team and Rehabilitation...

  • Sports Medicine Physician

    2 months ago

    French Camp, California, United States Department of Veteran Affairs Full time

    Department of Veteran Affairs is dedicated to providing a comprehensive range of health services to our nation's veterans, ensuring they receive the highest quality of care. Position Overview: The Sports Medicine Physician role is crucial within the Interdisciplinary Amputee Clinic Team and Rehabilitation Service Team. This position is focused on delivering...

  • Physician Sports Medicine Specialist

    3 weeks ago

    French Camp, California, United States Department of Veteran Affairs Full time

    Job Title: Physician Sports MedicineWe are seeking a highly skilled Physician Sports Medicine to join our team at the Department of Veteran Affairs in Stockton, CA.About the Role:The successful candidate will be responsible for providing high-quality patient care in the Polytrauma/TBI clinic, other clinics as determined by departmental need, as well as by...

  • Sports Medicine Physician

    2 months ago

    French Camp, California, United States Department of Veteran Affairs Full time

    Department of Veteran Affairs is dedicated to providing a comprehensive range of health care services to Veterans. Our mission is to ensure that those who have served our country receive the highest quality of medical attention. Position Overview: The Sports Medicine Physician plays a crucial role within the Interdisciplinary Amputee Clinic Team and...

  • Physician Sports Medicine Specialist

    3 days ago

    French Camp, California, United States Department of Veteran Affairs Full time

    The Department of Veteran Affairs is seeking a highly skilled Physician Sports Medicine Specialist to join our team at the VA Northern California Health Care System. As a key member of our Interdisciplinary Amputee Clinic Team and Rehabilitation Service Team, you will provide support in the delivery of care for our veterans.The ideal candidate will have...

Compliance Operations Manager

2 months ago

French Camp, California, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time
Position Overview

The anticipated compensation range is influenced by various factors including location, experience, education, and market conditions. This range may be adjusted.

We are seeking a Compliance Operations Manager (Non-Clinical A&O) to become a vital part of our organization.

Remote position available for candidates residing in California.

Key Responsibilities:

Under general oversight, this role involves crafting and executing strategic business plans while supervising internal and delegated non-clinical operations to guarantee adherence to state, federal, and NCQA standards, as well as organizational objectives. The work is diverse, moderately intricate, and necessitates a fair amount of discretion and independent decision-making.

Our Vision:

To continuously enhance the health of our community.

Our Mission:

To deliver healthcare value and promote wellness through community collaborations.

Core Duties:

  • Organizes and allocates tasks; oversees departmental workload to ensure compliance with regulatory standards; implements timely and effective adjustments as necessary.
  • Acts as the compliance expert in collaboration with non-clinical business units to enforce regulatory and contractual obligations.
  • Partners with internal stakeholders to devise and implement strategies aimed at improving compliance among delegates concerning non-clinical regulatory and contractual standards.
  • Collaborates with operational leadership to contribute to the creation, approval, and assessment of delegation agreements and related responsibilities.
  • Manages the collection and analysis of data from multiple sources to enhance departmental processes and audits, including surveys, meetings, trends, and feedback.
  • Investigates and assesses industry trends related to delegation oversight and program integrity.
  • Provides assistance to internal non-clinical departments to fulfill regulatory obligations, accreditation criteria, or other operational needs.
  • Supervises the review and upkeep of documentation, including standard operating procedures, process maps, auditing tools, and training for staff and external audit experts.
  • Leads and executes internal audits of non-clinical operational functions concerning regulatory and contractual obligations, including the development and refinement of audit tools and reporting results.
  • Facilitates audits with state and federal entities, including reviewing audit submissions and preparing report requests.
  • Issues corrective action plans for internal and external non-compliance with organizational policies, regulatory, and contractual standards; collaborates to ensure the effective resolution of these plans. Participates in the Audit and Oversight Committee to ensure adherence to regulatory and contractual obligations.
  • Compiles, develops, and oversees the submission of internal and external non-clinical reports.
  • Establishes, implements, and maintains records, documents, policies, and procedures related to audits and monitoring.
  • Fosters an environment that aligns with the organization's strategy, vision, mission, and values.
  • Recruits, supervises, and retains skilled personnel.
  • Achieves departmental objectives by collaborating with the Clinical Manager to ensure effective planning and execution of departmental goals, as well as audit and monitoring initiatives.

Qualifications:

Knowledge, Skills, Abilities, and Competencies

Required:

  • Comprehensive understanding of the non-clinical delegation oversight process within a regulated managed care setting, including Claims Operations and Processing, Network Adequacy, Cultural Linguistic, and Customer Service.
  • Thorough knowledge of state, federal, and NCQA regulations and standards pertaining to Medi-Cal and/or Medicare (D-SNP).
  • Extensive knowledge of audit and monitoring processes, including the implementation of controls, performance dashboard analysis, root cause evaluation, and effective management of corrective action plans.
  • Ability to identify, implement, monitor, and analyze relevant non-clinical metrics models, and execute effective interventions based on findings.
  • Financial insight: Interprets and applies understanding of key financial indicators to enhance business decisions.
  • Ability to manage complexity: Analyzes complex, high-volume data sets (e.g., audit universe review) and ambiguity to effectively address challenges.
  • Decision-making proficiency: Makes informed and timely decisions that advance organizational objectives.
  • Strategic perspective: Anticipates future possibilities and translates them into innovative strategies.
  • Resourcefulness: Efficiently allocates and utilizes resources; organizes personnel and resources to tackle challenges and seize opportunities.
  • Planning and alignment: Prioritizes work for self and others to meet commitments aligned with organizational goals.
  • Accountability: Holds self and others responsible for meeting commitments.
  • Results-driven: Consistently achieves outcomes, even in challenging circumstances.
  • Persuasive communication: Utilizes compelling arguments to garner support and commitment from others.
  • Collaborative spirit: Builds partnerships and works jointly with others to achieve shared goals.
  • Adaptability: Adjusts approach and demeanor in real-time to align with the changing demands of various situations.
  • Resilience: Recovers from setbacks and challenges when confronted with difficult situations.
  • Strong analytical skills, including the ability to synthesize, distill concepts, draw conclusions, and identify implications.
  • Excellent oral and written communication skills, with the ability to engage professionally with diverse individuals and groups both internally and externally.
  • Interpersonal effectiveness, with the ability to establish and maintain productive working relationships with individuals at all levels.
  • Proficient presentation skills, including the ability to tailor presentations to specific audiences and highlight key messages.
  • Solid understanding of change management principles, with the ability to implement them effectively.
  • Demonstrated project management skills and the ability to lead complex initiatives, including conducting cost-benefit and comparative analyses.
  • Strong process management skills, including the establishment of systems, processes, standards, and operating procedures.
  • Exceptional customer service skills.
  • Proven ability to articulate and support the organization's vision, mission, values, and strategy, integrating them into management practices and promoting their embodiment among staff.
  • Strong leadership and supervisory skills, with the ability to manage staff in a manner that maximizes performance and business outcomes.
  • Proficient report writing skills with expertise in Microsoft Excel and other reporting tools.
  • Ability to handle confidential information with appropriate discretion.
  • Experience in hiring, supervising, and retaining skilled personnel.

Education and Experience:

Required:

  • Bachelor's degree in Health Plan Administration, Business Administration, or a related field; and
  • A minimum of five years of experience in healthcare administration or a similarly regulated industry; and
  • At least three years of supervisory experience; or
  • An equivalent combination of education and experience.

Preferred:

  • Master's degree (MBA, MHA) or a related field is preferred.
  • Experience in managing operational and/or vendor compliance and oversight of healthcare-related activities.

Licenses and Certifications:

Required:

  • None.

Benefits:

We offer:

  • Competitive salary
  • Comprehensive and affordable health/dental/vision plans with provider options
  • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee's birthday, and 9 paid holidays)
  • CalPERS retirement pension program with automatic employer-paid contributions, in addition to a voluntary defined contribution plan
  • Two flexible spending accounts (FSAs)
  • Employer-Paid Term Life and AD&D Insurance
  • Employer-Paid Disability Insurance
  • Employer-Paid Life Assistance Program
  • Health Advocacy services
  • Supplemental medical, legal, and identity theft protection
  • Access to exclusive discount programs
  • Education and training reimbursement along with employer-paid elective learning courses.
  • An opportunity to work for a mission-driven organization that prioritizes our members and community.
  • A shorter commute for those traveling from the Central Valley to the Bay Area.
  • Visibility and variety in your role, working with individuals at all levels and on diverse projects.

We are an equal opportunity employer, valuing diversity as one of our core principles. We believe that diverse backgrounds, including race, ethnicity, gender, sexual orientation, and other characteristics, contribute to a strong organization that is responsive to the needs of those we serve. Employment decisions are based on qualifications and merit.

We provide equal employment opportunities to employees and applicants and prohibit discrimination based on color, race, gender (including gender identity and expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation, or any other characteristic made unlawful by applicable laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between the organization and the employee performing the job. The duties listed may be modified at the discretion of the organization, and employees may be asked to perform tasks not specified in this description.