Compliance Analyst

Lakeside Medical Northridge, CA
Regal-Net

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

We currently have an openings for a Compliance Analyst:

Delegation (Compliance) Data Analyst is assigned specific health plans and is responsible, through a series of activities, for facilitating and submitting accurate, complete, and timely required UM and CM health plan reports.

1. Complete and thorough understanding of the required reports and submission their deadlines.

2. Establish relationships with health plan contacts.

3. Act as the liaison for any inquires related to UM/CM reporting from the group to the health plan contact.

4. Work with decision support to facilitate the generation of automated reports.

5. Collaborate with operational teams to ensure that data on automated reports is being pulled from appropriate sources.

6. Work with operational teams to obtain manual logs/ reports/files required for reporting.

7. Facilitate the automation of manual reports whenever possible.

8. Provide report templates to decision support containing instruction on where/how the data will be pulled internally.

9. Ensure most current version of report template is being utilized.

10. Review updated report templates, compare to old versions and report changes along with new template to decision support.

11. Keep an updated record and evidence of all report submissions.

12. Review reports for accuracy and completeness prior to submission.

13. Report issues related to internal processes (i.e. timeliness issues) to the Director.

14. Internally request reports timely from either decision support or operational team.

15. Meet health plan reporting deadlines.

16. Collaborate with Compliance Analyst so that each has a general understanding of the others reporting requirements to ensure coverage.

17. Maintain up to date dashboard of report metrics as specified below.

18. Maintain an updated library of report templates in a central location.

19. Maintain an updated list of all standard reporting that is due for assigned health plans in a central location.

20. Attend health plan meetings/trainings relating to reporting and as needed. Qualifications:1. High school graduate required; Associates in Arts or higher degree preferred.

2. Minimum of two years of prior experience in healthcare environment required, with data analysis or project management experience

3. Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point).

4. Must have excellent communications skills both verbally and written.

5. Typing 60 words per minutes with accuracy. Knowledge of Excel, tables and pivot tables. Knowledge of Microsoft Access program

6. Ability to deal with responsibility with confidential matters.

7. Must have strong organization skills.

8. Ability to work in a multi-task, high stress environment.

9. Must be able to handle multiple projects at one time, reset priorities day-to-day to meet deadlines, and know when to ask for assistance and direction when working with conflicting priorities.

10. Must be self-motivated, pleasantly aggressive and realistically ambitious and have high personal ethics.

11. Must have the ability to work with all levels of management and have the ability to develop positive working relationships with health plan auditors and company department heads.

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.