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DMHC Compliance Analyst
Ref No.: 17-01825
Category: Health Information Management
Location: Rancho Cucamonga, California
We are seeking a DMHC Compliance Analyst to work with a large Health Plan in California.
Compliance Consultant
Job Summary:
  • Responsible for leading State Programs activities and initiatives as related to the California Department of Managed Health Care (DMHC)
  • Manages, creates and maintains internal and external relationships.
  • Identify risks, create and/or revise current State Programs and Plan processes/policies and procedures to ensure compliance and reduce risks, communicate regulatory changes to the Plan and lead workgroups to ensure implementation of required changes are completed by the responsible business unit
  • Lead and/or participate in relevant committees and workgroups; make presentations, prepare reports, data or other materials for presentation/training.
  • Participates in and support other components of the Plan's compliance program, such as Privacy, Data Security, Code of Business Conduct and Ethics, Fraud Waste & Abuse, etc.
  • 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 heath care compliance, health care operations, health care administration, project management/oversight, regulatory or public policy development, legal or health plan governance experience.
  • Experience with California Department of Managed Health Care (DMHC) preferred
  • Experience with publicly funded managed care.
  • Experience interacting with regulatory agencies.
  • Experience in a pediatric setting / working with children.
  • Ability to work independently and collaboratively within a team environment.
  • Strong organizational skills and attention to detail.
  • Ability to manage multiple projects with competing deadlines and changing priorities.
  • Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, Outlook, and Access.

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