Clinical Compliance Professional, CenterWell
About the positionResponsibilities• Assesses the compliance risks to PCO and leverages the assessment to design the auditing and monitoring activities included in the workplan. • Executes assigned portions of the PCO compliance workplan throughout the year. • Regularly conducts compliance related audits to assess internal controls, examining healthcare records and processes, and analyzing and reporting risks. • Influences department strategy by identifying and overseeing the development of continuous monitoring activities.• Provides reporting on metrics and M&A activity. Requirements• Bachelor's degree. • 2 or more years in healthcare related field. • Compliance regulations knowledge and compliance auditing experience. • Knowledge/understanding of laws and regulations governed by the DOJ and CMS. • Must be able to work core business hours on EST time between (9am-4pm). • Ability to travel up to 15% to conduct audits at site locations. • Effective verbal and written communication skills. • Strong attention to detail. • Ability to articulate findings and impacts.• Familiarity with healthcare provider compliance, mainly primary care, hospital, and/or pharmacy. • Ability to manage multiple competing priorities and meet deadlines. • Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Nice-to-haves• CHC certification or similar. • Medicare Risk Adjustment Experience. • Clinical background preferred, with Part B and Specialist experience a plus. • Ability to analyze large data sets. • Experience or knowledge of Accountable Care Organizations (ACO) preferred.• Six Sigma or Lean Certified. • Graduate degree, MBA or Healthcare focus a plus. • Experience with metrics and reporting. Benefits• Medical, dental and vision benefits. • 401(k) retirement savings plan. • Paid time off, including company and personal holidays, volunteer time off, paid parental and caregiver leave. • Short-term and long-term disability. • Life insurance. Apply tot his job