What are the responsibilities and job description for the Compliance Specialist position at PMH Careers?
Under the direction of the Director of Compliance Programs and in support of the Vice President of Compliance, this position will assist in the coordination and implementation of Compliance Programs responsibilities and delegated oversight activities with contracted health plans, entities and vendors. Assist in monitoring business activities for compliance when regulations change, support departments and company strategies to ensure compliance with federal, State, and contractual healthcare requirements. Assist in audit preparation and the development of reports/tools to monitor and track implementation and completion of corrective measures. Supports the compliance team on general standards of conduct, FDR, FWA, OIG, HIPAA related matters. Cooperates with management, collaborates with cross-functional teams and performs other duties as assigned. Knowledge of Medicaid, Medicare and Medi/Medi regulations applicable to health plans and IPA’s required.
