Job Summary
Responsible for managing, planning, organizing, coordinating, and improving the functions associated with accreditation and regulatory compliance and ensuring that El Paso First Health Plans, Inc. (El Paso Health) meets and exceeds continuous state, federal and administrative regulatory compliance and accreditation requirements. Responsible for ensuring compliance with Texas Health and Human Services Commission (HHSC) and Centers for Medicare and Medicaid Services (CMS) regulations and expectations, including creating and monitoring policies and reports (deliverables). Assist in all Compliance Department duties related to the Medicaid, STAR PLUS and Medicare lines of business. Works closely with the Chief Compliance Officer and Compliance Director as well as interfacing with all other operational departments. Responsible for the Supervision of the Compliance Claims Auditor(s) and the Compliance Analyst(s). 

Skills
1. Strong verbal and written communication skill.
2. Excellent presentation skills, as well as conceptual and analytic skills in order to review and articulate company objectives and Federal regulations across all relevant audiences.
3. Highly detail orientated.
4. Ability to analyze and solve problems.
5. Ability to develop policies and procedures.
6. Ability to be a self-starter and follow through on projects with minimal management oversight. 
7. Ability to coordinate professional staff at all levels on multiple projects to ensure deadlines and objectives are met.
8. Ability to seek out new methods and principles to improve services.
9. Bilingual in English and Spanish preferred.

Work Experience
One year of supervisory experience required. Demonstrated experience in managed care government programs (Medicaid, CHIP, STAR PLUS, Medicare/Medicare Advantage) required. Experience working with managing compliance with laws and regulations, writing policies and procedures, working with quality improvement and/or regulatory compliance required.

License/Registration/Certification
None.

Education and Training
Bachelor degree in Health Care or Business related fields required.