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Senior Compliance and Risk Management Specialist

2 months ago

Honolulu, Hawaii, United States Centerwell Full time
Join Our Team at Centerwell

As a vital member of our dedicated community, you will play a crucial role in prioritizing health and safety.

Position Overview
The Senior Compliance and Risk Management Specialist is responsible for identifying and evaluating potential risks to mitigate losses effectively. This role involves addressing moderately complex to intricate challenges where thorough analysis of data and situations is essential.

Key Responsibilities
  • Develop and enforce compliance policies and procedures, ensuring adherence to governmental regulations.
  • Conduct research on compliance matters and propose necessary modifications to enhance compliance.
  • Assess the potential impact of losses and implement strategies to minimize organizational risks.
  • Make informed decisions on complex issues related to project components independently.
  • Oversee the compliance program by estimating risks, conducting audits, and providing guidance to the business.
  • Prepare comprehensive compliance reports and data analytics for senior management and regulatory bodies.
  • Ensure project and departmental objectives are achieved efficiently.
  • Contribute to the long-term development and execution of risk and compliance assessment plans.
  • Proactively identify compliance challenges and integrate business knowledge to address them effectively.
  • Lead and participate in cross-functional committees, representing the Risk Management Department.
  • Design and deliver compliance training programs.
  • Assist management with federal, state, and administrative disclosure requirements.
  • Review data for potential instances of fraud, waste, and abuse.
  • Manage external vendors to ensure timely and budget-compliant deliverables.
  • Support additional Risk Management Department initiatives as needed.

Required Qualifications
  • Bachelor's Degree in a relevant field.
  • A minimum of five years of experience in healthcare compliance, risk management, or a related area.
  • In-depth knowledge of healthcare compliance laws and regulations.
  • Exceptional verbal, interpersonal, and written communication skills.
  • Proven ability to distill complex information into clear and actionable insights.
  • Experience in identifying and implementing process improvements.
  • Strong relationship-building skills with stakeholders at all levels.
  • Excellent project management capabilities, with the ability to prioritize tasks effectively.
  • Intermediate proficiency in Microsoft Office applications, particularly Excel and PowerPoint.

Preferred Qualifications
  • Advanced degree or relevant certification.
  • Experience in a healthcare provider organization.
  • Prior knowledge of Medicare and Medicaid regulations.
  • Healthcare Compliance Certification or equivalent professional credential.

Additional Information
Willingness to travel as required for various clinic locations.