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Commodore Offshore Operating, LLC
Los Angeles, CA, United States
The Compliance Coordinator provides systemic and advisory support to the organization on regulations and compliance involving GOM Shelf LLC assets. This position is expected to oversee and maintain compliance management systems, act as a focal point of communications between government agencies and GOM Shelf LLC, prepare and execute facility modifi
Job Source: Commodore Offshore Operating, LLCMedPOINT Management
Los Angeles, CA, United States
Job Description Job Description Summary MedPOINT Management is committed to conducting its business and operations in accordance with the highest legal and ethical standards. Our Code of Conduct sets forth our expectations of management, employees, and contractors to act in accordance with applicable laws and Company policy. MedPOINT’s Complianc
Job Source: MedPOINT ManagementPreferred IPA of California
Los Angeles, CA, United States
Job Description Job Description Openings for both a Quality Compliance Nurse and a Compliance Coordinator. QUALITY COMPLIANCE NURSE PURPOSE: The Quality and Compliance Nurse is responsible for working with the Medical Director, the VP of Clinical Policy, the QM Committee in developing, implementing, and refining the Quality Management Program.
Job Source: Preferred IPA of CaliforniaRiboliwines
Los Angeles, CA, United States
The Human Resource Team is seeking a Benefits and Compliance Coordinator to assist the Senior HR Leadership team with ensuring we are in compliance and up to date with training, benefits and state/federal requirements. This individual should be a self-starter, collaborative, comfortable working within ambiguity and employee experience driven. This
Job Source: RiboliwinesRiboli Family Wines
Los Angeles, CA, United States
Build your career at Riboli Family Wines! Riboli Family Wines is of the fastest-growing wine manufacturers in the U.S. and has received the designation of American Winery of the Year. We are a family-owned business, four generations deep, with 100+ years of producing well-known wines. Our company's leading wine brands include Stella Rosa, San Anton
Job Source: Riboli Family WinesAlo Yoga
Los Angeles, CA, United States
OVERVIEW We are seeking a diligent and detail-oriented Trade Compliance Specialist to join our team. The Trade Compliance Specialist will be responsible for ensuring that our organization operates within legal and regulatory frameworks, upholds ethical standards, and mitigates compliance risks effectively. The ideal candidate will possess strong a
Job Source: Alo YogaUniversity of Southern California
Los Angeles, CA, United States
RSO Compliance Coordinator page is loaded RSO Compliance Coordinator Apply locations Los Angeles, CA time type Full time posted on Posted Yesterday job requisition id REQ20147690 The RSO Compliance Coordinator is part of the Campus Activities team and reports to the Assistant Director of Campus Activities, Campu
Job Source: University of Southern CaliforniaMedPOINT Management
Los Angeles, CA, United States
Job DescriptionJob Description Summary Under the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profil
Job Source: MedPOINT ManagementLos Angeles, CA, United States
Job Description Job Description Summary
Under the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special projects, ensuring projects are completed timely and successfully. The Compliance Coordinator must have the ability to deliver quality results with tight deadlines and maintain accurate records and documentation.
Duties and Responsibilities
• Requests, collects an distributes a variety of documentation from departmental teams necessary to facilitate the auditing and monitoring functions
• Ensures auditing and monitoring documentation is complete, and received in a timely manner
• Maintain MedPOINT and Health Plan training materials
• Collect and store all provider training materials for plan, State and Federal audit needs
• Generate and distribute departmental provider warning and non-compliant letters
• Review and validate all letter templates to comply with Health Plan, State and Federal regulatory standards
• Oversees member notice process for accuracy and compliance
• Manage corrective action plans and reporting needs
• Interacts with departmental and MedPOINT stakeholders for deliverable reviews and approvals
• Conducts process reviews to ensure validity and accuracy of analytical results
• Prepare and submit all standard and nonstandard compliance documents and researching related issues of highly complex nature and recommending solutions
• Aggregate and analyze audit findings into a reportable format; to include, monthly, quarterly, or annual delegation activities
• Assist in the revision of delegation oversight audit tools in accordance with standards set by ICE, NCQA, the Plan’s policies and procedures, and other State and Federal guidance tools as required
• Maintains and updates status logs for assigned projects, contributes to, or produces delegation oversight activity reports to management
• Ensure HIPAA compliance is always observed/performed
• Understand and follow the MPM Employee Handbook policies and procedures
• Perform additional duties/assignments as needed
Minimum Job Requirements
• Bachelor’s Degree
• 2+ years Managed Care or Healthcare experience in Provider Network Management, a plus
• Knowledge of Health Plan Provider Network oversight and audit processes, a plus
• Ability to identify, analyze, and interpret trends or patterns
• EZ-CAP knowledge and experience, a plus
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
Skill and Abilities
• Effective verbal and written communication skills, a must • Exceptional attention to details
• Excellent planning, analytical, and organizational skills
• Ability to prioritize and manage multiple tasks and projects simultaneously • Strong interpersonal skills; ability to collaborate effectively with both internal and external contacts • Demonstrated critical thinking and problem-solving skills
• Ability to work independently and take direction
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PNO Compliance Coordinator jobs in Los Angeles, CA, United States
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