Company:
AHI agilon health, inc.
Job Posting Location:
Remote - USA
Job Title:
Healthcare Compliance Analyst
Job Description:
Position Summary:The Corporate Compliance Analyst (“Analyst”) will assist in the successful administration of an effective Compliance Program following state and federal regulatory requirements and agilon health policies and procedures.
Required Qualifications:
- Minimum Experience
- Three+ years compliance experience, preferably in healthcare or a managed care setting
- Three+ years experience in compliance auditing and monitoring
- Experience with regulatory agencies such as CMS, NCQA, OIG & DOJ
- Experience with laws pertaining to HIPAA Security & Privacy, Fraud Waste and Abuse
- Knowledge of health plans, medical groups, and managed care operations and related functions and regulations
- Education/Licensure:
- Bachelor’s degree in healthcare or related field required.
- Certification in Healthcare Compliance (CHC) preferred
Essential Job Functions:
- Supports the Compliance team in implementing the Annual Compliance Work Plan, agilon health Code of Conduct, Conflict of Interest Program, and Annual Training.
- Assists in the implementation and monitoring of compliance controls, compliance procedures, and operational processes per the compliance plan.
- Supports vendor oversight activities, including precontracting assessments, routine audits, and annual attestations.
- Supports ACO Compliance activities, including assisting with internal/external audits, corrective action plans, ad-hoc requests, CMS portal/4i/ACO-MS submissions/monitoring, supporting the development of board materials, and assisting with the implementation of the annual ACO Compliance Work Plan.
- Supports global policy lifecycle management for the organization by managing related schedules, version control, and ensuring timely maintenance of related systems and databases.
- Supports audit activities by performing related analysis, maintaining schedules, drafting and managing communications, and organizing information in various systems and databases.
- Assists in developing and analyzing key statistics and trends of agilon Health’s compliance functions for presentation to the Chief Compliance Officer and board, and for risk mitigation and improvement opportunities.
- Maintains working knowledge of healthcare compliance legal and regulatory requirements.
- Supports a culture of compliance that ensures effective lines of communication are accessible to all employees and FDRs.
- Maintains oversight over Compliance inquiries, incident tracking, investigating, completion, and remediation.
- Assists in triaging, routing, and reporting Compliance workload from various sources.
- Supports the department developing content and presentations for the Compliance Committee, including information related to identified issues, investigations, and remediation efforts.
Other Job Functions:
- Understand, adhere to, and implement the Company’s policies, procedures, Code of Conduct, and Mission, Vision, and Values.
- Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
- Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
- Engage in excellent communication which includes listening attentively and speaking professionally.
- Demonstrate attention to detail and accuracy in work product.
- Some travel involved.
- Skills and Abilities:
- Demonstrate executive presence in interactions with your team and throughout the organization
- Experience with GRC systems (e.g., SAI360, OneTrust, AuditBoard, etc.) a plus
- Familiarity with HIPAA and its application to current business functions
- Understanding of the health care industry, including payor and provider settings
- Excellent written and verbal communication skills
- Exercise attention to detail; ability to provide accurate data entry
- Self-starting with the ability to work under pressure with moderate supervision, multi-task, and complete projects in a timely fashion; meeting deadlines is a must
- Excellent analytical, problem solving and organizational skills a must.
- ACO Compliance experience (preferred)
- Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.
- Computer Skills: advanced ability using Microsoft Office (Word, Excel, Outlook, PowerPoint)
Location:
Remote - TX
Pay Range:
$24.00 - $28.70
Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.
