Regulatory Compliance Expert
hace 7 horas
Regulatory Compliance Expert
About the Role:We are seeking an experienced Regulatory Compliance Expert to join our team at Target Human Resources Solutions. In this role, you will be responsible for performing ongoing risk assessment activities focused on regulatory and compliance areas associated with organizational operations and performance.
Key Responsibilities:- Risk Assessment and Compliance Oversight
- Oversee the creation and maintenance of a structured monitoring process regarding regulatory & compliance areas, liaising with key members of Management and other departments within APS.
- Manage and assure completion of auditing activities through effective performance, time/budget management, progress metrics, and effective report revisions.
- Provide periodic and/or requested reporting to key business leaders regarding compliance plan, schedules and status.
- Perform all corresponding investigations regarding instances of non-compliance with State and Federal Laws & Regulations, healthcare utilization, corporate policies and procedures.
- Report any identified or referred instances of non-compliance with State and Federal Laws & Regulations, to the Compliance Officer and Committee.
- Elaborate reports and statistical analysis based on all instances of non-compliance with State and Federal Laws & Regulations, healthcare utilization, corporate policies and procedures.
- Elaborate and conduct compliance trainings to APS-PR personnel in collaboration with the Compliance Manager.
- Bachelor's Degree in Business Administration, Managed Care or a Behavioral Health Field; Master's Degree preferred.
- Minimum 3 years of experience in auditing, financial auditing, compliance, healthcare, care management or related field preferred.
- Knowledge of the healthcare industry and managed care processes.
- Knowledge regarding audit processes and work plans preferred.
- Knowledge of current Fraud, Abuse and Waste deterring techniques preferred.
- An estimated salary of $85,000 - $110,000 per year, depending on location and experience.
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