FDR Compliance Analyst (Remote)
Why This Role is Important to Us:
Under the direction of the Compliance Training, Education & Communications Manager, the primary focus of this position is to support compliance-related programs such as internal Compliance Training, Education, and Communication, Conflict of Interest, Compliance Effectiveness program and others as developed.
This position is also responsible for updating and tracking metrics/data for completion rates, engagement, and effectiveness.
What You'll Be Doing:
Serve as a core member of the compliance department, supporting organizational projects aimed at promoting and maintaining an effective Compliance Program.
Elements of the Training and Education Program include:
Coordinate compliance training programs and facilitate education and awareness campaigns around compliance
Assist in the development of Annual Compliance Education Training for the Workforce and Board of Directors
Maintain accurate training records, as required for compliance program effectiveness
Identify need for and develop ad hoc trainings as needed
Conduct regulatory and contractual research as requested
Assist in the development and delivering of compliance training content
Maintain tracking and dashboard metrics of compliance reporting status
Assist in maintaining Compliance, Training, Education, and Communication Program including:
Develop, maintain, and update Standard Operating Procedures for Compliance Training and Education Program
Document training activities and maintain appropriate training records
Develop and implement an effective Compliance Month educational experience for CCA workforce
Work collaboratively with Health Plan Compliance team to assist with maintaining oversight of first tier, downstream and related entities to monitor compliance with required training components
Develop regulatory and enterprise-wide communication content as needed for publication
Represent Compliance department at meetings
Assist in the development and delivery of Compliance Tips of the Month and other compliance education initiatives (Lunch & Learns/ Corporate Compliance week)
Assist in the creation of training guides and delivering training on CCA's developing Governance, Risk and Compliance platform.
Lead and/or assist with training in classroom settings, one-on-one, meetings, webinars, and workshops
Perform other job-related duties as assigned Focused Compliance
Responsibilities:
Administrator for Reporting Requirements
Develop/monitor individual module project plans to ensure established schedule is maintained
Develop/maintain system roles-based access requirements where needed
Develop reports within the system for distribution among the organization
Point person for end-user questions for reporting
Identify and scope identified, needed system enhancements
Develop/maintain process documentation
Become subject matter expert relating to training, education, and communications activities Analyst
Responsibilities:
Serve as a liaison between data analysts and business departments to translate business functions needing compliance oversight into data requirements for reports and dashboards
Proactively clarify scope and requirements to provide accurate status of projects and timely delivery of reports
Develop relevant metrics and alerts for prospective data issues
Ensure consistency / standards across all reports, dashboards, and tools through extensive quality control and review process
Ensure appropriate data gathering, reports, and analysis are in place to meet certain CMS and State requirements
Track, analyze and resolve data inaccuracies and/or negative data trends (duplicates, incomplete information, inconsistencies, etc.
) and engage appropriate stakeholders
Record, respond, and help resolve data issues in a proactive manner Data Analysis:
Identify key data findings and trends in projects through graphical visualizations
Interpret data accurately and produce clear and comprehensive written analyses, dashboards, graphs, tables, etc.
for diverse internal and external audiences
Disseminate and interpret data reports/graphs
Create data visualizations to effectively display performance trends using tools such as Excel (pivot tables), Tableau, Looker, and SQL server
Analyze sets of data into clear and concise observations
Develop and analyze quantitative reports to assess performance on key measures Process Improvement:
Partner with business units to develop and track performance towards achieving benchmarks on key regulatory requirements
Facilitate exploratory sessions to develop a shared understanding of a business problem, the possible solutions and next steps.
Document requirements based on the outcome of the sessions
Identify opportunities for continuous improvement based on data findings Development of metrics and reporting to demonstrate effectiveness of CCA's Compliance Program:
Identify, develop, and produce metrics to demonstrate effectiveness of CCA's Compliance Program.
Work collaboratively with all divisions within Compliance Department
Oversee and manage processes that generate Compliance data to ensure compliance data meets all requirements for applicable transparency laws and regulations governing the industry
Prepare metrics and reports for consumption by different levels within the organization.
Review certain issue notifications/disclosures and assign compliance risk level.
Work collaboratively with impacted departments to identify root cause and make recommendations for corrective actions, as identified.
Review and analyze state and federal regulations and requirements:
Assist in processing regulatory guidance, including but not limited to, HPMS Memoranda, Federal Register, and/or OIG notifications and other regulatory guidance.
Create summaries of changes to requirements and regulations, and identify business owners, impacted departments and required next steps for implementation.
Coordinate distribution, comment collection and submission process for updated regulations Secondary
Responsibilities:
Support overall Regulatory and Compliance Infrastructure Work with Compliance Specialist -Training to review and evaluate training documentation and needs of the organization.
Monitor training completion metrics.
Serve as Regulatory Affairs and Compliance liaison with key internal departments
Provide guidance and assistance as requested
Hold meetings with department leadership at agreed upon intervals
Attend department staff meetings and present information as requested
Assist in development of regulatory toolkits and instruction materials as needed to assist departments with regulatory projects and process implementation
Support business units in interpretation of regulations related to their applicable areas as well as provide assistance in developing appropriate tools to ensure compliance
Provide consultation with business owners in developing policies and procedures and/or building internal workflows to ensure internal controls of high-risk regulatory requirements are in place and working effectively Prepare and coordinate regulatory filings as required
Work with business owners to develop reporting playbooks to support CCA's regulatory and contractual reporting requirements.
Assist in obtaining attestations for regulators as needed
Assist in the coordination of communications, data collection, organization, and submission of materials for external reviews and audit requests, as required
Assist in the oversight of the corporate Compliance Plan and identification of compliance risks
Assist in maintaining an effective compliance plan at CCA by promoting compliance with all compliance plan elements
Develop new processes and/or programs as directed What We're Looking For:
Education Required:
Bachelor's degree or equivalent work experience is required.
Experience Required:
1-2 years' work experience Experience Desired:
Regulatory compliance experience preferred; health care compliance programs experience strongly preferred.
Knowledge, Skills & Abilities Required:
Project management skills - having the ability to effectively manage multiple priorities simultaneously by maintaining established timeframes, adhering to work plans, and communicating changes effectively, demonstrate attention to detail.
Strong written, verbal, listening and communication skills -- having the ability to understand and communicate appropriately to the targeted audience.
Must be able to effectively communicate with colleagues, internal customers, and vendors.
Data analytical skills.
Strong analytical skills -- having the ability to identify an issue, conduct an analysis to determine business impact (including gap analysis), troubleshoot and identify solutions.
Candidate must be able to prioritize work and use independent judgment.
Self-directed with proven initiation skills.
Ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions.
Knowledge, Skills & Abilities Desired:
A background with Medicare, Medicaid and/or health plan operations is preferred.
Experience with health care compliance programs is also preferred.
EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer.
Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Recommended Skills Analytical Attention To Detail Auditing Business Process Improvement Campaigns Communication Estimated Salary: $20 to $28 per hour based on qualifications.
Under the direction of the Compliance Training, Education & Communications Manager, the primary focus of this position is to support compliance-related programs such as internal Compliance Training, Education, and Communication, Conflict of Interest, Compliance Effectiveness program and others as developed.
This position is also responsible for updating and tracking metrics/data for completion rates, engagement, and effectiveness.
What You'll Be Doing:
Serve as a core member of the compliance department, supporting organizational projects aimed at promoting and maintaining an effective Compliance Program.
Elements of the Training and Education Program include:
Coordinate compliance training programs and facilitate education and awareness campaigns around compliance
Assist in the development of Annual Compliance Education Training for the Workforce and Board of Directors
Maintain accurate training records, as required for compliance program effectiveness
Identify need for and develop ad hoc trainings as needed
Conduct regulatory and contractual research as requested
Assist in the development and delivering of compliance training content
Maintain tracking and dashboard metrics of compliance reporting status
Assist in maintaining Compliance, Training, Education, and Communication Program including:
Develop, maintain, and update Standard Operating Procedures for Compliance Training and Education Program
Document training activities and maintain appropriate training records
Develop and implement an effective Compliance Month educational experience for CCA workforce
Work collaboratively with Health Plan Compliance team to assist with maintaining oversight of first tier, downstream and related entities to monitor compliance with required training components
Develop regulatory and enterprise-wide communication content as needed for publication
Represent Compliance department at meetings
Assist in the development and delivery of Compliance Tips of the Month and other compliance education initiatives (Lunch & Learns/ Corporate Compliance week)
Assist in the creation of training guides and delivering training on CCA's developing Governance, Risk and Compliance platform.
Lead and/or assist with training in classroom settings, one-on-one, meetings, webinars, and workshops
Perform other job-related duties as assigned Focused Compliance
Responsibilities:
Administrator for Reporting Requirements
Develop/monitor individual module project plans to ensure established schedule is maintained
Develop/maintain system roles-based access requirements where needed
Develop reports within the system for distribution among the organization
Point person for end-user questions for reporting
Identify and scope identified, needed system enhancements
Develop/maintain process documentation
Become subject matter expert relating to training, education, and communications activities Analyst
Responsibilities:
Serve as a liaison between data analysts and business departments to translate business functions needing compliance oversight into data requirements for reports and dashboards
Proactively clarify scope and requirements to provide accurate status of projects and timely delivery of reports
Develop relevant metrics and alerts for prospective data issues
Ensure consistency / standards across all reports, dashboards, and tools through extensive quality control and review process
Ensure appropriate data gathering, reports, and analysis are in place to meet certain CMS and State requirements
Track, analyze and resolve data inaccuracies and/or negative data trends (duplicates, incomplete information, inconsistencies, etc.
) and engage appropriate stakeholders
Record, respond, and help resolve data issues in a proactive manner Data Analysis:
Identify key data findings and trends in projects through graphical visualizations
Interpret data accurately and produce clear and comprehensive written analyses, dashboards, graphs, tables, etc.
for diverse internal and external audiences
Disseminate and interpret data reports/graphs
Create data visualizations to effectively display performance trends using tools such as Excel (pivot tables), Tableau, Looker, and SQL server
Analyze sets of data into clear and concise observations
Develop and analyze quantitative reports to assess performance on key measures Process Improvement:
Partner with business units to develop and track performance towards achieving benchmarks on key regulatory requirements
Facilitate exploratory sessions to develop a shared understanding of a business problem, the possible solutions and next steps.
Document requirements based on the outcome of the sessions
Identify opportunities for continuous improvement based on data findings Development of metrics and reporting to demonstrate effectiveness of CCA's Compliance Program:
Identify, develop, and produce metrics to demonstrate effectiveness of CCA's Compliance Program.
Work collaboratively with all divisions within Compliance Department
Oversee and manage processes that generate Compliance data to ensure compliance data meets all requirements for applicable transparency laws and regulations governing the industry
Prepare metrics and reports for consumption by different levels within the organization.
Review certain issue notifications/disclosures and assign compliance risk level.
Work collaboratively with impacted departments to identify root cause and make recommendations for corrective actions, as identified.
Review and analyze state and federal regulations and requirements:
Assist in processing regulatory guidance, including but not limited to, HPMS Memoranda, Federal Register, and/or OIG notifications and other regulatory guidance.
Create summaries of changes to requirements and regulations, and identify business owners, impacted departments and required next steps for implementation.
Coordinate distribution, comment collection and submission process for updated regulations Secondary
Responsibilities:
Support overall Regulatory and Compliance Infrastructure Work with Compliance Specialist -Training to review and evaluate training documentation and needs of the organization.
Monitor training completion metrics.
Serve as Regulatory Affairs and Compliance liaison with key internal departments
Provide guidance and assistance as requested
Hold meetings with department leadership at agreed upon intervals
Attend department staff meetings and present information as requested
Assist in development of regulatory toolkits and instruction materials as needed to assist departments with regulatory projects and process implementation
Support business units in interpretation of regulations related to their applicable areas as well as provide assistance in developing appropriate tools to ensure compliance
Provide consultation with business owners in developing policies and procedures and/or building internal workflows to ensure internal controls of high-risk regulatory requirements are in place and working effectively Prepare and coordinate regulatory filings as required
Work with business owners to develop reporting playbooks to support CCA's regulatory and contractual reporting requirements.
Assist in obtaining attestations for regulators as needed
Assist in the coordination of communications, data collection, organization, and submission of materials for external reviews and audit requests, as required
Assist in the oversight of the corporate Compliance Plan and identification of compliance risks
Assist in maintaining an effective compliance plan at CCA by promoting compliance with all compliance plan elements
Develop new processes and/or programs as directed What We're Looking For:
Education Required:
Bachelor's degree or equivalent work experience is required.
Experience Required:
1-2 years' work experience Experience Desired:
Regulatory compliance experience preferred; health care compliance programs experience strongly preferred.
Knowledge, Skills & Abilities Required:
Project management skills - having the ability to effectively manage multiple priorities simultaneously by maintaining established timeframes, adhering to work plans, and communicating changes effectively, demonstrate attention to detail.
Strong written, verbal, listening and communication skills -- having the ability to understand and communicate appropriately to the targeted audience.
Must be able to effectively communicate with colleagues, internal customers, and vendors.
Data analytical skills.
Strong analytical skills -- having the ability to identify an issue, conduct an analysis to determine business impact (including gap analysis), troubleshoot and identify solutions.
Candidate must be able to prioritize work and use independent judgment.
Self-directed with proven initiation skills.
Ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions.
Knowledge, Skills & Abilities Desired:
A background with Medicare, Medicaid and/or health plan operations is preferred.
Experience with health care compliance programs is also preferred.
EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer.
Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Recommended Skills Analytical Attention To Detail Auditing Business Process Improvement Campaigns Communication Estimated Salary: $20 to $28 per hour based on qualifications.
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