Compliance Specialist - Jefferson Health Plan

Jefferson Health

Philadelphia, Pennsylvania, United States of America
3 years managed care operations experience
Knowledge of cms and dhs compliance standards
Experience with regulatory submission tracking
This position supports the administration and oversight of Health Partners Plans' Compliance Program to ensure ongoing compliance with state and federal requirements

Job Summary

  • This position supports the administration and oversight of Health Partners Plans' Compliance Program to ensure ongoing compliance with state and federal requirements.
  • The role involves researching regulatory issues, maintaining full compliance for Medicare Advantage, Pennsylvania Medicaid, and CHIP lines of business, and assisting in audit investigations.
  • Jefferson Health offers a comprehensive benefits package including medical, dental, vision, retirement plans, and tuition assistance at Thomas Jefferson University.

Matching Summary

This position supports the administration and oversight of Health Partners Plans' Compliance Program to ensure ongoing compliance with state and federal requirements.

Skills & Requirements

Must-have

  • 3 years managed care operations experience
  • Knowledge of CMS and DHS compliance standards
  • Experience with regulatory submission tracking

Nice-to-have

  • Strong written and verbal communication skills
  • Ability to work independently and collaboratively
  • Experience developing job aids for compliance

Key Requirements

  • Bachelor's Degree preferred
  • 3 years firm managed care operations or compliance experience required
  • 1 year demonstrated experience with Compliance program management preferred

Work Rights

Not specified

Tailored Resume

Cover Letter