Compliance Analyst

Company:AHI agilon health, inc.

Job Posting Location:Remote - USA

Job Title: ​Compliance Analyst

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.

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.

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
• 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: ​Remote - CaliforniaPay Range: ​$24.00 - $28.70

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.