Healthcare Compliance Specialist

2 weeks ago


Topeka, Kansas, United States Evolent Health Full time
About the Role

Evolent Health is seeking a highly skilled Correspondence Policy Specialist to join our Shared Services team. As a key member of our team, you will play a critical role in ensuring compliance with legislative and accreditation requirements, while maintaining high-quality clinical correspondence.

Key Responsibilities
  • Develop and customize correspondence templates according to regulatory requirements and contractual obligations.
  • Provide oversight of the use of appropriate correspondence and review requests for new or modified templates.
  • Collaborate with Compliance to ensure clinical correspondence meets minimum standards for National Committee for Quality Assurance, Utilization Review Accreditation Commission, Employee Retirement Income Security Act of 1974, and Centers for Medicare and Medicaid Services.
  • Update clinical correspondence templates as needed to ensure compliance with regulatory requirements.
  • Research state regulatory requirements for clinical correspondence and policies using online technology and research tools.
  • Consult with IT to support the letter generation process.
Requirements
  • 3+ years of healthcare industry experience.
  • 3+ years of experience with compliance and quality requirements related to healthcare and UM processes.
  • Associates degree or higher preferred.
  • Strong analytical and problem-solving skills.
  • Excellent verbal and written communication skills.
  • Knowledge of legislative/oversight bodies.
What We Offer

Evolent Health is an equal opportunity employer and offers a comprehensive benefits package, including health insurance benefits, to qualifying employees. This position is eligible for a bonus component based on pre-defined performance factors.



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