FamilyCare, Inc. is a Medicaid and Medicare healthcare Coordinated Care Organization based in Portland, Oregon. We embody our mission statement--Creating Healthy Individuals through Innovative Systems--in everything we do. Our dedication to customer service has earned us an outstanding reputation in the Northwest healthcare industry.
We believe that in order to build on our nearly 30 year tradition of success, we must continue to seek out and attract talented individuals. We offer a challenging work environment with opportunities for growth and development. Communication is encouraged, and excellence is rewarded. FamilyCare offers a generous and highly competitive benefits package which includes health, dental, and vision insurance as well as a 401k plan with employer contribution, and liberal annual PTO.
FamilyCare, Inc. is seeking an innovative and forward thinking Regulatory Compliance Coordinator who will provide oversight and coordination of external audits. They will also be responsible for ensuring timely submission of all contractual and regulatory reporting; as well as assisting the Compliance Program Manager in implementing program/process changes that support a comprehensive approach to corporate compliance in the continuation of FamilyCare's Mission to Create Healthy Individuals through Innovative Systems.
• Bachelors Degree in Business Administration, Health Administration, or related area or equivalent combination of education and work experience leading to expertise in role is required
• Minimum of two (2) years of compliance experience.
• Strong understanding of HIPAA regulations
• Certified in Healthcare Compliance preferred
• Experience in healthcare / health insurance industry preferred.
• Strong understanding of CFRs and OARs related to DMAP, CMS and AMH, Contracts.
• Function as key compliance representative to provide guidance to management and staff on compliance concerns
• Responsible for timely submission of contractual and regulatory reporting requirements, notifications
• Act as problem solver to ensure that compliance issues/concerns within organization are appropriately evaluated, investigated and resolved.
• Oversight of annual CMS Data Validation process (Part C and D, encounter data).
• Assist with implementing program / process changes to remediate identified compliance risks
• Responsible to collect and organize regulatory data for presentation to Senior Management and Board of Directors
• Provide oversight and coordination of external audits.