Healthcare Compliance Analyst

Company:

Job Posting Location:

Job Title: ​

Job Description: ​

Position Summary:

The Corporate Compliance Analyst (“Analyst”) will assist in the successful administration of an effective Compliance Program following state and federal regulatory requirements and agilon health policies and procedures.

Required Qualifications:

• Minimum Experience
  • Three+ years compliance experience, preferably in healthcare or a managed care setting
  • Three+ years experience in compliance auditing and monitoring
  • Experience with regulatory agencies such as CMS, NCQA, OIG & DOJ
  • Experience with laws pertaining to HIPAA Security & Privacy, Fraud Waste and Abuse
  • Knowledge of health plans, medical groups, and managed care operations and related functions and regulations
• Education/Licensure:
  • Bachelor’s degree in healthcare or related field required.
  • Certification in Healthcare Compliance (CHC) preferred

Essential Job Functions:

• Supports the Compliance team in implementing the Annual Compliance Work Plan, agilon health Code of Conduct, Conflict of Interest Program, and Annual Training.
• Assists in the implementation and monitoring of compliance controls, compliance procedures, and operational processes per the compliance plan.
• Supports vendor oversight activities, including precontracting assessments, routine audits, and annual attestations.
• Supports ACO Compliance activities, including assisting with internal/external audits, corrective action plans, ad-hoc requests, CMS portal/4i/ACO-MS submissions/monitoring, supporting the development of board materials, and assisting with the implementation of the annual ACO Compliance Work Plan.
• Supports global policy lifecycle management for the organization by managing related schedules, version control, and ensuring timely maintenance of related systems and databases.
• Supports audit activities by performing related analysis, maintaining schedules, drafting and managing communications, and organizing information in various systems and databases.
•  Assists in developing and analyzing key statistics and trends of agilon Health’s compliance functions for presentation to the Chief Compliance Officer and board, and for risk mitigation and improvement opportunities.
• Maintains working knowledge of healthcare compliance legal and regulatory requirements.
• Supports a culture of compliance that ensures effective lines of communication are accessible to all employees and FDRs.
• Maintains oversight over Compliance inquiries, incident tracking, investigating, completion, and remediation.
• Assists in triaging, routing, and reporting Compliance workload from various sources.
• Supports the department developing content and presentations for the Compliance Committee, including information related to identified issues, investigations, and remediation efforts.

Other Job Functions:

• Understand, adhere to, and implement the Company’s policies, procedures, Code of Conduct, and Mission, Vision, and Values.
• Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
• Engage in excellent communication which includes listening attentively and speaking professionally.
• Demonstrate attention to detail and accuracy in work product.
• Some travel involved.
• Skills and Abilities:
  • Demonstrate executive presence in interactions with your team and throughout the organization
  • Experience with GRC systems (e.g., SAI360, OneTrust, AuditBoard, etc.) a plus
  • Familiarity with HIPAA and its application to current business functions
  • Understanding of the health care industry, including payor and provider settings
  • Excellent written and verbal communication skills
  • Exercise attention to detail; ability to provide accurate data entry
  • Self-starting with the ability to work under pressure with moderate supervision, multi-task, and complete projects in a timely fashion; meeting  deadlines is a must
  • Excellent analytical, problem solving and organizational skills a must.
  • ACO Compliance experience (preferred)
  • Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.
  • Computer Skills: advanced ability using Microsoft Office (Word, Excel, Outlook, PowerPoint)

Location: ​

Pay Range: ​

Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.