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Regulatory Compliance Coordinator - Compliance - Full Time - Days at ProMedica Health

Posted in Compliance 30+ days ago.

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Type: Full Time
Location: Maumee, Ohio

Job Description:

Job Title
Regulatory Compliance Coordinator - Compliance - Full Time - Days
Office / Administrative / Clerical
Organizational Unit
ProMedica - Paramount - Paramount - Compliance (8820)
Maumee, OH 43537 US (Primary)
Job Description

Thank you for inquiring about a position with Paramount. We are a NCQA accredited managed care plan, which is part of ProMedica s integrated healthcare system with offices in Maumee, Columbus, Cleveland, and Cincinnati. Paramount provides health insurance coverage for Medicare, Medicaid, and Commercial members. For more information about Paramount, please visit our website

Our mission is to improve your health and well-being. So we re committed to your wellness with various initiatives, such as preventive services, online knowledge, health risk assessments, our Steps2Health disease management programs, health fairs, and more.

The Paramount Compliance Team is currently recruiting for a Regulatory Compliance Coordinator. The Regulatory Compliance Coordinator is responsible for assisting the Regulatory Compliance Team Leader with programs, policies, and practices that ensure all products of ProMedica Insurance Corporation and its subsidiary companies are in compliance with federal, state, and local laws, as well as all regulatory requirements.

The Coordinator will be required to:

- Remain current on compliance requirements and upcoming changes for assigned line of business;

- Assist with maintenance and review of policies, procedures and practices to ensure compliance with laws, regulations, and government program contract requirements;

- Assist with internal monitoring and corrective action for detected non- compliance;

- Assist with external compliance audits;

- Assist with investigation of state and federal regulator queries, investigations and/or complaints filed by enrollees/providers with state and federal regulators;

- Participate on internal compliance committee or workgroups as assigned, including but not limited to HIPAA investigations;

- Work closely with Commercial Marketing, Elite and Advantage departments on compliance oversight for their respective line(s) of business;

- Assist with activities related to reducing vulnerability to fraud, waste, and abuse; and,

- Assist with the content, implementation and delivery of compliance related training. Job Requirements

* Bachelor s Degree in a related area required.

* Master s Degree preferred.

* Minimum of three to five years regulatory compliance experience required.

* Demonstrated technical knowledge of health insurance, managed care and government programs compliance/regulatory matters required.

* Excellent verbal and written communications skills sufficient to interact will all levels of employees required.

* Ability to plan, coordinate, and organize multiple priorities with minimal supervision.

* Experience using Microsoft Office programs, especially Excel, Word, and Power Point required.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.

Equal Opportunity Employer/Drug-Free Workplace Employee Exemption Type
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On-call Requirements

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