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Manager of Compliance, Auditing and Monitoring
Ref No.: 17-01824
Category: Health Information Management
Location: Rancho Cucamonga, California
We are seeking a Compliance Manager to oversee Auditing and Monitoring at a large Health Plan in California.
Manager of Compliance, Auditing and Monitoring
Job Summary:
  • Assist Compliance Officer and Director of Compliance with carrying out their respective roles in overseeing legal, regulatory and company policy compliance by providing knowledge and support in the areas of clinical documentation standards, regulatory compliance, third-party payer requirements, and auditing/monitoring standards and practices. Manages, creates and maintains internal and external relationships.
  • Serves as the responsible person for gathering, analyzing and reporting results of Ethics and Compliance initiatives related to compliance auditing and monitoring activities into data trend models for system-wide effective reporting and risk assessment.
  • Function as a communication liaison concerning compliance matters between the Compliance Committee.
  • Directs and manages the day-to-day operations of the Auditing & Monitoring Unit.
  • Directs the unit in a course to ensure quality and accuracy of the work produced.
  • Must be well versed in current healthcare compliance issues, OIG enforcement activities, and other applicable regulations such as HIPAA, licensure requirements, and quality standards.
  • Ensure follow up reviews are conducted by auditing, monitoring or otherwise of areas previously found non-compliant to determine if the implemented corrective actions have fully addressed the underlying problem.
  • Ensure privacy and security of PHI as outlined in the Plan's policies and procedures relating to HIPAA compliance.
Qualifications:
  • Bachelor's Degree required, Master's preferred
  • Minimum five (5) years of audit experience in healthcare (hospital systems, medical groups, third-party payers)
  • Three (3) years of management experience
  • Must have demonstrated current knowledge of business ethics and compliance risks and the knowledge to assist with management of those risks in a dynamic health care environment.
  • Must develop and maintain excellent interpersonal relationships within the department and at all levels of the organization.
  • Must have excellent written and verbal communication skills, including ability to present regulatory requirements, directives, ideas and concepts effectively to a diverse audience.
  • Requires strong leadership skills, along with the ability to effectively supervise assigned staff

Compensation:
  • Competitive pay rates!
  • Great Benefits!
  • Inquire for more details