Compliance Administrator

Foothill Ranch, CA 92610

06 Months Contract

Note: Hybrid, individual in Foothill Ranch office minimum one day per week.

Job Description Summary:

• Thoroughly prepares, researches, and completes California Department of Managed Health Care (DMHC) reports and amendment filings, business partners/carrier reporting requirements, and any other requirements set by state and federal agencies (including, but not limited to: Medicare Advantage (MA), Department of Insurance (DOI), and Employee Retirement Income Security Act (ERISA)).
• Reviews related regulations and performed analysis to assure all requirements are met and filed within the deadline. Thoroughly and timely tracks reporting deadlines by month and logs all in-process and completed reports.
• Prepares and/or oversees internal claims and quality management/utilization management audit results and findings.
• Prepares documents for presentation to the Quality Management Committee, Public Policy Committee, Board of Directors, and Management Team.
• Provides oversight with the compliance work plan and monitoring functions and activities including risk assessment.

Job Type: Contract

Pay: $30.00 - $32.00 per hour

Schedule:

• 8 hour shift
• Day shift

Ability to commute/relocate:

• Foothill Ranch, CA: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Compliance management: 1 year (Required)
• Regulatory reporting: 1 year (Required)

Work Location: One location