Now hiring a Hybrid Regulatory Compliance Specialist in Alameda, CA. The Regulatory Compliance Specialist would be working with a health insurance organization. This would be full time / 40 hours per week.

If you are interested in this Regulatory Compliance Specialist position, please contact Corrin Misak at cmisak@alinestaffing.com or (586) 710-7958.

Regulatory Compliance Specialist Highlights

• Job Summary: Under the direction of the Manager, Regulatory Affairs & Compliance, the Regulatory Compliance Specialist supports the compliance program by coordinating implementation of new and revised healthcare rules and requirements as are communicated by state agencies.
• Location: Alameda, CA
  • Hybrid - require weekly reporting to the office in Alameda
• Required Availability: 8am-5pm PST M-F
• This position is a W2 temporary/contract assignment currently scheduled through 08/12/2024
• Pay rate: $80,000 - $120,000 based on experience and qualifications
• • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Regulatory Compliance Specialist Responsibilities:

• Read, review and summarize prospective, new and revised rules and healthcare policy from local, state and federal agencies, including but not limited to, the Department of Managed Health Care (DMHC), the Department of Health Care Services (DHCS), and Centers for Medicare & Medicaid Services (CMS).

• Coordinate with internal departments to gather data and information for regulatory submissions.

• Schedule and lead meetings with stakeholders to review analysis, discuss key points, next steps, and potential issues affecting implementation.

• Documents all actions taken by stakeholders to maintain a clear written record of the chronology of implementation for tracking and transparency.

• Assist with the completion of CMS, DMHC and DHCS submission, amendments and material modifications related to all policy preparation, implementation and execution

• Assist with internal information gathering as may be required during audits and other requests from state agencies.

• Participate in and represent the Alliance at state agency and professional association meetings, trainings, conferences and webinars related to new regulatory mandates, regulatory updates, new member benefits and changes to existing member benefits

• Participate in and represent the Compliance Department on internal committees and work groups related to prospective, new or revised legislation and policy work.

• Assist in coordinating state and federal audit visits and complete responses.

• Assist in the implementation of audit processes to ensure compliance with federal and state statutes and regulations and program guidance.

• Research questions from staff regarding regulatory compliance.

• Maintain knowledge of business products and related Alliance policies and procedures and alert the compliance staff of non-compliance risks.

• Distributes the Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS) All Plan Letters (APL) and other regulatory policy guidance to internal stakeholders in a timely manner.

• Complete other special projects and duties as assigned.

Education/Experience:

• Bachelor’s degree or equivalent experience required.

• Familiarity with Medicaid (Medi-Cal), Medicare and other publicly funded programs preferred.

• One-to-Three-year related experience in healthcare preferably in a managed care setting.

• Understanding of federal and state regulatory bodies and processes.
• Proficiency in correct English usage, grammar, and punctuation.
• Ability to communicate effectively, both verbally and in writing.
• Exemplary interpersonal skills including ability to collaborate effectively as part of a team across organizational structure is a must.
• Ability to ability to think critically, make informed decisions and work independently with minimal supervision.
• Excellent organizational skills and orientation to detail.
• Proven ability to prioritize and manage multiple projects simultaneously and meet deadlines.
• Experience in use of computer system software such as MS Word, Excel, Access, Outlook, SharePoint, and PowerPoint.
• Familiarity with SmartSheet and Team Dynamics (TDX) a plus.

If you think this Regulatory Compliance Specialist position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!

Corrin Misak – Staffing Manager II

cmisak@alinestaffing.com or (586) 710-7958