Job Details
Job Location: Sacramento - California
Position Type: Full Time
Salary Range: Undisclosed
Job Shift: Day
Job Summary
Lead Compliance Excellence
Oversee and Ensure State & Federal Adherence for CA Medicaid with Expertise in DMHC, DHCS.
The Compliance Officer California State Medicaid will oversee and ensure that the company adheres to all relevant California state and federal regulations. This role involves the development, implementation, and monitoring of compliance programs to ensure the company operates in accordance with Medicaid requirements for the designated state. The Compliance Officer will collaborate with internal teams and external agencies to manage risks and implement corrective actions as needed.
Expertise Required in CA: DMHC, DHCS, and California Medicaid programs.
Key Responsibilities:
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Ensure compliance with all California state Medicaid regulations, including the Department of Health Care Services (DHCS) and other applicable government agencies.
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Develop, implement, and monitor compliance programs specific to Medicaid dental insurance services.
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Collaborate with Corporate Compliance on audits and regulatory reviews, ensuring preparedness and addressing findings effectively.
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Establish and enforce standards and procedures to prevent, detect, and correct improper or illegal conduct.
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Collaborate with the legal and operations teams to assess and mitigate compliance risks related to Medicaid contracts and services.
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Serve as the point of contact for all compliance-related issues and inquiries regarding Medicaid dental insurance business.
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Conduct training programs to educate staff on compliance-related matters, ensuring alignment with Medicaid requirements.
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Investigate compliance issues and work with internal teams to resolve them in a timely manner.
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Prepare and submit required reports to regulatory bodies and Medicaid authorities as needed.
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Maintain knowledge of industry trends and best practices related to compliance in the Medicaid dental insurance space.
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Develop corrective action plans and ensure compliance with California state and federal guidelines during implementation.
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Monitor California state Medicaid Policies and Procedures (P&P) to ensure compliance with the California state Medicaid contract.
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Monitor and track high risk compliance issues which may expose LIBERTY to sanctions, penalties, liquidated damages, Corrective Action Plans (CAPs), and/or fines.
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Monitor all Medicaid contractual commitments to ensure contractual obligations are met.
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Oversee the onboarding and monitoring of all approved Medicaid subcontractors/vendors by National Compliance.
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Collaborate with National Compliance regarding the responses to regulatory inquiries and regulatory audits which involve the Medicaid contract.
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Track new requirements specific to the Medicaid Contract and provide guidance to business owners on existing and new California state Medicaid requirements.
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Collaborate with Corporate Compliance to investigate HIPAA, Privacy, and Security issues related to the Oklahoma Medicaid Contract.
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Attend regulatory meetings as needed.
What You'll Need!
Education
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Bachelor's degree in Healthcare Administration, Law, Business, or a related field; Graduate degree preferred.
Experience
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Certification in healthcare compliance (CHC) or Certified Compliance and Ethics Professional (CCEP) preferred.
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Minimum 6 years' experience in compliance roles, with a focus on Medicaid programs within the dental or healthcare insurance industry.
Specific Skills/Knowledge
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Comprehensive knowledge of Medicaid laws, regulations, and state-specific requirements.
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Experience managing audits and regulatory reviews related to Medicaid services.
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Excellent communication skills, with the ability to collaborate effectively across departments.
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Strong problem-solving and analytical skills to handle complex compliance challenges.
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Detailed knowledge of Medicaid program requirements, particularly DHCS, CMS, and other relevant California state regulations.
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Strong ability to assess compliance risks and propose mitigation strategies.
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Excellent organizational skills and the ability to manage multiple priorities in a fast-paced environment.
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Proficient in compliance-related reporting and documentation.
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Leadership abilities to guide compliance efforts and foster a culture of adherence to regulations.
Location
Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.
What Liberty Offers
Happy, healthy employees enhance our ability to assist our members and contribute more actively to their society. That’s why Liberty offers competitive and attractive benefit packages for their employees. We strive to care for employees in positive ways that promotes wellness and productive employees.
Our first-class benefit package supports our employees and their dependents with:
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Competitive pay structure and saving options that help you reach your financial goals
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Excellent 401k retirement benefits available which includes employer match and ability to save via a Roth IRA, plus immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!
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Medical insurance offered with low-cost premium for employee only coverage and Liberty subsidizes 50% of dependent coverage for eligible enrolled dependents.
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100% employer paid dental coverage for employees and eligible dependents.
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100% employer paid vision coverage for employee only coverage, low-cost premium for dependents!
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Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.
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Long Term Disability coverage
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Expansive wellness program including companywide Get Active challenges and Burn-A-Long with option for gym discounts.
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Employee Assistance Program
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Generous vacation and sick leave with the ability to roll time over.
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10 paid company holidays
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Birthday flex holiday
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Tuition Reimbursement
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Remote or Hybrid options for various positions
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And so much more...
Compensation
In the spirit of pay transparency, we are excited to share the base salary for this position is $130,000 - $160,000, exclusive of fringe benefits or potential bonuses. If you are hired at Liberty, your final base salary compensation will be determined based on factors such as geographic location, skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any, final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical in order to allow for future & continued salary growth.
Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture.
Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.
We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.
Sponsorship and Relocation Specifications
Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.
No relocation assistance or sponsorship available at this time.
