Compliance Coordinator at Medical Transportation Management in Lake Saint Louis, Missouri

Job Description:

What Will Your Job Look Like?

The Compliance Coordinator plays a vital role in ensuring MTM’s overall contractual compliance by partnering with various departments throughout the organization to develop and implement long-term compliance solutions.  A Compliance Coordinator is responsible for monitoring potential Fraud, Waste, and Abuse (FWA) by performing investigations, facilitating member appeals and transportation provider appeals, and overseeing the performance improvement plan (PIP) process for transportation providers.  The Compliance Coordinator also acts as a liaison and provides support to auditors as they review operational processes, policies and procedures, and contract management functions.  The Compliance Coordinator will help oversee Quality Improvement Plans, audits, provider assessment reviews, and assesses liquidated damages.

This is a hybrid of Work from home and 2 days in our Lake St. Louis office.

What You’ll Do:

• Create contractual compliance monitoring tools and matrixes to ensure compliance metrics are sustained, follow best practices, and ensure all validation and quality requirements are met and documented


• Utilize large datasets to identify potential compliance deficiencies and monitor and maintain audits to reduce or define deficiencies


• Develop project plans, tracking and trending mechanisms to correct any identified deficiencies as well as identify focus areas for improvement to strengthen MTM’s Compliance Program


• Investigate and provide determinations to all member appeals and State Fair Hearing requests in accordance with contractual obligations using MTM and client protocols


• Read, comprehend, and apply contract document requirements, including application of contract verbiage and requirements for the operational processes of the organization


• Ownership and creation of PIPs for transportation providers by monitoring the dissemination of PIPs to transportation providers, including the progress made by transportation providers while actively on PIPs


• Facilitate internal audits including, conduct process reviews, conduct transportation provider focus audits, and document and report audit findings


• Own quality improvement plans and monitor progress to ensure compliance is achieved


• Assist auditors with external audits by providing support with audit tool completion, sample documentation compilation, and attending on site audits as needed


• Communicate information to Quality and Compliance Committee, Department heads and Executive Leadership; present findings as necessary to Leadership and external stakeholders


• Compile records, reports, investigation results, and audit findings as requested for external clients and state entities


• Monitor operational SLAs for Executive Leadership Team and identify risks for consideration


• Manage net promoter scores and satisfaction surveys for internal and external clients


• Provide recommendations for systematic internal controls and process changes to ensure ongoing compliance for corrected deficiencies; includes assisting in implementation of remediation to address compliance concerns


• Proactively identify, prevent, and report potential FWA to Leadership and external clients, make determinations for cases involving fraud, appeals, denials and LDs, and make recommendations for improvement based on findings


• Facilitate the pre-assessment and liquidated damage process by investigating and making determinations to pre-assessment review requests and liquidated damage appeals using contractual documents to determine accuracy


• Manage and/or assist with other internal and external special projects and tasks as needed


• Collaborate with other departments and provide education of protocols, processes and procedures


• Act as back-up to co-workers as required and cross-train in all department functions

What You’ll need:

• High School Diploma or G.E.D.


• Bachelor’s Degree or equivalent relevant experience


• Experience managing multiple priorities and initiatives with stringent deadlines


• Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint and SharePoint)

Even better if you have...

• Previous experience in contract compliance and/or operational auditing role preferred


• Basic understanding of SQL and/or XML preferred


• Detail-oriented, thorough, and systematic/methodical approach to projects


• Strong analytical and problem-solving skills


• Strong project management and organizational skills


• Strong communication skills


• Basic to intermediate understanding of data base/system concepts and/or design


• Ability to complete basic to intermediate data analysis and trending


• Ability to multi-task, set priorities, meet deadlines, and work well under pressure and in a fast-paced environment


• Ability to maintain high level of confidentiality


• Regular attendance is required

What’s in it for you:

· Health, Life Insurance, Dental and Vision Plans

· 401(k) with a company match

· Paid Time Off, Holiday Pay and Birthday Holiday

· Maternity/Paternity Leave

· Casual Dress Environment

· Tuition Reimbursement

· MTM Perks Discount Program

· Leadership Mentoring Opportunities

Salary Min: $52,000

Salary Max: $52,000

• This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss with us as you move through the selection process.

Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM’s People & Culture.

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