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Job Details

Job Title
: Compliance Administrator
Required Skills
: Auditing, compliance, Insurance
Location
Duration
: 6 Months Contract

Job Description

Job Description:

Thoroughly prepares, researches, and completes California Department of Managed Health Care (DMHC) reports and amendment filings, business partners/carrier reporting requirements, and any other requirements set by state and federal agencies (including, but not limited to: Medicare Advantage (MA), Department of Insurance (DOI), and Employee Retirement Income Security Act (ERISA)).

Responsibilities:

  • Reviews related regulations and performs analysis to assure all requirements are met and filed within the deadline.
  • Thoroughly and timely tracks reporting deadlines by month and logs all in-process and completed reports.
  • Prepares and/or oversees internal claims and quality management/utilization management audit results and findings.
  • Prepares documents for presentation to the Quality Management Committee, Public Policy Committee, Board of Directors, and Management Team.
  • Provides oversight with the compliance work plan and monitoring functions and activities including risk assessment

Qualification:

  • Excellent verbal and written communication skills with the ability to formulate document content.
  • Ability to maintain the confidentiality of company documents and information
  • Experience with regulatory filings, particularly with California Department of Managed Health Care (DMHC)
  • Experience performing monitoring and oversight activities
  • Regulatory research experience
  • Experience with external or internal audits
  • Knowledge of Department of Insurance and CMS/Medicare regulations, a plus

Required Details

Experience
: 2-3 Years
Travel Required
: No
Clearance Required
: No

Contact Details

Contact person
: Uday Bhandary
Email
: udayb@suntechnologies.com
Phone
: 678-675-1014
Website
: https://www.suntechnologies.com

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