Job Title: Compliance Administrator
Exempt Status: Non-Exempt
Reports to: Sr Dir Infrastructure and Security
Episource, with over 4000 employees worldwide, is a leading provider of risk adjustment services and solutions for health plans. Our services help Medicare Advantage, Commercial/Exchange, and Medicaid managed care plans improve and support accurate reimbursement in a post-Affordable Care Act market. Our services include retrospective chart reviews, medical record retrieval, HEDIS/ACO quality reporting, and data analytics, allowing payers and providers to dramatically reduce costs and improve quality of care.
The Compliance Administrator will assist the Sr. Director of Infrastructure and Security and Compliance Manager with the company compliance program.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
- Assists in request for proposal (RFP) responses related to compliance program and prepares business responses for client requested compliance information.
- Assists with all new and recurring compliance certification initiatives (i.e. HiTrust, HIPAA, etc).
- Assists the business for all compliance audits and risk assessments (vendor and internal).
- Assists in the compliance communication program for the organization, including promoting a) use of the compliance hotline, b) heightened awareness of standards of conduct, and c) understanding of new and existing compliance issues and related policies and procedures.
- Coordinates internal and external resources related to 3rd Party Risk Assessments, Audits and compliance initiatives.
- Understands technical requirements and tools used in evidence gathering and audit compliance.
- Must have a deep sense of technology as related to compliance initiatives.
- Must maintain the ability to work in an environment with PHI / PII data.
- May be assigned other duties.
- Must maintain compliance with all company policies and procedures.
- Maintains current knowledge of federal and state compliance regulations.
- Provides reports on a regular basis, and as directed or requested, to Sr. Director of Infrastructure & Security and Compliance Manager informed of the progress of compliance efforts.
- Ensure proper reporting of violation or potential violations to Sr. Director of Infrastructure & Security and Compliance Manager.
Education / Requirements:
- Minimum Bachelor’s degree.
- Minimum of 5-7 years’ experience within tech or healthcare industry.
- Professional Certification preferred.
- Knowledge of Risk analysis frameworks.
- Knowledge of technical systems and their inter-relation and operation.
- Excellent Verbal and written communication skills, including ability to effectively communicate with internal and external customers.
- Excellent computer proficiency (MS Office-Word, Excel, Outlook).
- Demonstrated ability to adapt to change.
- Must be able to work under pressure and meet deadlines, while maintain a positive attitude and providing exemplary customer service.
- Ability to work independently and with teams to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting productivity standards.
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms
- Must be able to lift and carry up to 20 lbs.
- 10% of domestic travel. Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.
EEO POLICY STATEMENT:
Episource, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Episource, LLC complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation, and training.
Episource, LLC expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Episource, LLC employees to perform their expected job duties is absolutely not tolerated.