Compliance Administrator

Location:

Mason, Ohio

Duration:
Expected to be a 6-month contract with possible extension

Pay rate: $22/hr. The pay rate may differ depending on your skills, education, experience, and other qualifications.
Featured Benefits:

• Medical Insurance in compliance with the ACA
• 401(k)
• Sick leave in compliance with applicable state, federal, and local laws

Description: The Administrator-Compliance (Programs) is responsible for preparing, researching, and completing regulatory reports, amendment filings, and business partners/carrier reporting requirements. This includes operational processes and programs to assure compliance with various regulatory requirements such as Medicare Advantage (MA), Department of Managed Health Care (DMHC), Department of Insurance(DOI), and Employee Retirement Income Security Act (ERISA).

Compares and evaluates possible courses of action and makes recommendations to the Compliance Manager or leadership team. Assists the Compliance Manager in assuring compliance with policies, procedures, and requirements set by state and federal agencies. Modifies policies and procedures as necessary.

• Thoroughly prepares, researches, and completes DMHC reports and amendment filings, business partner/carrier reporting requirements, and any other requirements set by state and federal agencies.
• Reviews related regulations and performs analysis to assure all requirements are met and filed within the deadline.
• Thoroughly and timely tracks reporting deadlines by month and logs all in-process and completed reports.
• Prepares and/or oversees internal claims and quality management/utilization management audit results and findings in collaboration with the Manager – Compliance, Claims Manager/Team Leader, Quality Management VP/Team Leader, and Clinical Director.
• Prepares documents to be presented to the Quality Management Committee, Public Policy Committee, Board of Directors, and Management Team.
• Provides oversight with the compliance work plan and monitoring functions and activities, including risk assessment.
• Assists with the Language Assistance Program (LAP) activities such as staff language fluency assessment, monitoring the enrollee assessment report, Customer Service Department call log, and preparing and mailing required communications.
• Prepares reports, maintains files, and communicates the data and information associated with local, state, and federal regulatory guidelines for the network, including those set forth by the EPA, State EPAs, CalEPA, California CUPAs, and other state and local environmental regulatory agencies.
• Supports compliance with federal, state, and local environmental laws.
• Ability to work effectively with regulatory agencies while communicating with facilities throughout the U.S. and Canada regarding permits, inspections, and compliance requirements.
• Maintains general and up-to-date knowledge of fire protection systems and associated general regulatory compliance requirements.
• Acquires approval for environmental compliance-related payables and tracks invoices & check requests.
• General knowledge of SPCC plans and Stormwater Management Plans as they relate to operations.
• Familiarity with the Clean Air Act as they relate to operations.
• Familiarity with EPCRA requirements as they relate to operations.
• General knowledge of California special wastes as they relate to operations.
• General understanding of Environmental Management Systems.
• Maintains document files pertaining to audits and observations of workforce performance with regard to environmental compliance.
• Through observation of documents such as reports, permits, and inspection forms, detects potential environmental compliance problems of an accounting, bookkeeping, and clerical nature.
• Facilitates, arranges, and conducts environmental-related training and orientation as needed.