JOB SUMMARY: Support the Compliance Department for Imperial Health Plan of California, Inc. / Imperial Health Holdings Medical Group. May support the NCQA Accreditation Program and oversight processes, CMS compliance, medicare part D& C audits and accreditation best practices and ongoing training activities.
ESSENTIAL JOB FUNCTIONS:
MARGINAL JOB FUNCTIONS:
Takes on special projects as needed and requested.
Performs other duties as assigned.
BEHAVIORAL EXPECTATIONS:
Continuous Learning :
Attends staff meetings as required.
Attends appropriate training, seminars and workshops as required.
Customer Focus:
Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations and IMAS’s Standards of Conduct.
Fosters appropriate communication and relations with Supervisor, co-workers, and other staff.
Quality/Process Improvement/Safety
Reports issues of security, health and/or safety to appropriate supervisor as soon as practicable.
Supports and demonstrates safety throughout all duties performed.
Follows established policies and procedures and understands and complies with all regulators standards set forth by governing entities.
POSITION REQUIREMENTS:
Regulatory compliance
CMS
NCQA
Claims
EDUCATION/EXPERIENCE:
High school graduate or equivalent.
Bachelor’s Degree or equivalent combination of education and technical experience can substitute in lieu of degree.
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