ACA Senior Compliance Analyst PCHP

## ACA Senior Compliance Analyst PCHPApply:
Mockingbird Towers 4th FLR:
Full time:
Posted Today:
990786
** Special

Note:

Strong candidates will have experience with Affordable Care Act ACA-related regulations, compliance requirements, reporting, or administration rather than simply having general healthcare experience.*
* *
* Work schedule:

Hybrid / Full-time Days; 8 a.m. until 4 p.m., Monday through Friday*
* ** PRIMARY PURPOSE
** Responsible for the ongoing management of the Health Plan compliance policies, procedures and guidelines. This position supports the ongoing development, maintenance, review and assessment of PCHP’s compliance, evaluates changes in regulatory requirements and coordinates efforts to operationalize them across the Health Plan.  
** MINIMUM SPECIFICATIONS*
* ** Education*
* * Bachelor’s degree in Healthcare Administration, Business Administration or related field.
* Master’s degree in Healthcare Administration, Business Administration or related field is preferred.  
** Experience*
* * Five years of relevant professional experience as a healthcare compliance professional.
* Experience in designing and implementing organizational reporting processes and structures that enhance and encourage complete and accurate tracking, coordination and reporting of compliance activities and events.  
** Equivalent

Education and/or Experience *
* * Seven (7) years of experience in a comparable position working in commercial or Marketplace (ACA) health insurance, or with a health insurance issuer offering Qualified Health Plans, may be considered in lieu of a degree.  
** Certification/Registration/Licensure*
* * HCCA Certified in Healthcare Compliance (CHC) required within two years from the date of entry into the position.  
** Required Tests for Placement*
* * None.
** Skills or Special Abilities*
* * Excellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines. Ability to communicate complex information in understandable terms.
* Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships across and beyond the organization.
* Excellent analytical and problem-solving skills.
* Strong time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.
* Ability to write clearly and succinctly with a high level of attention to detail.
* Proficient computer and Microsoft Office skills. Ability to learn new software programs.
* Knowledge of the Affordable Care Act (ACA), Federally-facilitated Marketplace and Qualified Health Plan (QHP) requirements, National Committee for Quality Assurance (NCQA), the Texas Insurance Code, and applicable federal regulations (45 CFR).  
** Responsibilities*
* ** Regulatory and Compliance:*
* * Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements.
* Responsible for understanding and applying ACA/Marketplace regulations and requirements including 45 CFR Parts 153, 155, and 156, the Texas Insurance Code, TAC, and applicable CMS and Texas Department of Insurance (TDI) guidance.
* Prepares, coordinates, and tracks regulatory filings and submissions, including TDI form and rate filings (SERFF), QHP certification and recertification materials, and required CMS/Marketplace data submissions.
* Attends meetings hosted by regulatory agencies and tracks completion of compliance-related action items.
* Develop compliance committee agendas, presentations, and minutes.  
** Reporting and Monitoring:*
* * Maintains log and reporting of internal monitoring and compliance risks.
* Assists with the creation and implementation of…