Title: Temp – Administrative – Quality Improvement and Compliance (Days) Dallas, TX
Description: Local candidates preferred
- This position is a hybrid working position, you
must be living in the DFW or surrounding area. Access to high-speed internet and secure
working environment is required. All equipment will be provided
| Primary Purpose |
The Parkland Community Health Plan (PCHP)
Compliance Analyst gathers and analyzes clinical and financial data that assists
with driving practice
transformation, quality program
compliance and improved patient care. Assists the Compliance Manager
in the execution of the organizations compliance program by performing regulatory compliance reviews that test
and monitor the compliance with laws and regulations. Provide support to the
department in responding to the business units regarding day-to-day operational
compliance questions. Responsibilities : - Collects, maintains, and audits compliance/regulatory matters
database to ensure records are accurate, complete, and fulfill legal
requirements.
- Identifies and researches gaps in documentation, or potential areas of non-compliance, and suggests resolutions.
- Coordinates, responds and participates in external client
audits and CMS and state
regulatory audits.
- Develops appropriate compliance reports, including dashboards, tracking logs and summary
reports that communicate the status of the compliance program to leadership.
- Provides development guidance
and assists in the identification, implementation, and
maintenance of compliance policies, procedures and work instructions.
- Assists in developing, producing and conducting compliance training programs.
- Assists managing relationships with regulatory agencies
and seek to resolve policy
issues which may negatively
impact service to members.
- Builds and maintains strong collaborative working
relationships across PCHP's functional areas including legal, contracting, provider
relations, member relations, utilization management, quality monitoring and information
systems.
- Serves as a company wide resource and liaison on policies, contract
issues and provisions, communications, workflow, and
quality improvements initiatives.
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