Compliance Specialist II

Job Description

Central California Alliance for Health is seeking a Compliance Specialist II to join their Compliance Department. The Compliance Specialist will report to the Compliance Manager and will be responsible for conducting reviews of contractual provisions and regulations, researching compliance questions, assisting with internal and external audits, coordinating delegate oversight activities, and ensuring subcontractors' compliance.

• Conducts regular on-going review and analysis of relevant contractual provisions and state and federal statutes and regulations
• Researches questions from staff regarding regulatory compliance and responds to external requests for information
• Assists with the implementation of internal and external audit processes
• Coordinates Alliance delegate oversight activities
• Performs other duties as assigned

Ideal candidates should have experience in a managed care or healthcare environment, knowledge of Medi-Cal and Medicare Advantage programs, experience in audits and monitoring, strong attention to detail, remote work experience, excellent multitasking skills, and the ability to meet strict deadlines.

• Experience working in a managed care or healthcare environment
• Knowledge of the Medi-Cal and Medicare Advantage programs and related regulations
• Experienced in audits and monitoring, risk assessment, and/or delegate oversight
• Acute attention to detail and data accuracy
• Experience working remotely
• Excellent multitasking skills
• Efficient with their time and can meet strict deadlines
• Knowledge of compliance programs and regulatory processes
• Knowledge of quality improvement practices and audit techniques
• Knowledge of research, analysis, and reporting methods
• Knowledge of State and Federal legislative processes
• Ability to understand Alliance roles and responsibilities
• Ability to research and interpret legal materials
• Ability to learn and apply state and federal regulations
• Ability to demonstrate strong analytical and research skills

The Alliance offers medical, dental, and vision plans, ample paid time off, paid holidays, a retirement plan, a deferred compensation plan, a health and wellness program, and onsite EV charging stations.

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations