Virginia Premier Health Plan, Inc.

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Compliance Analyst II

Compliance Analyst II

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4391

Job Description

Overview

Provide assistance to the Compliance Manager in the management and implementation of the Medallion 3.0 and MLTSS contracts and Virginia Premier’s Program Integrity Compliance Program and assists in overseeing all ongoing activities related to the development, implementation, and maintenance of the organization’s privacy policies in accordance with applicable federal and state laws. Maintain knowledge of regulatory requirements for organizational impact and implementation. Advise and collaborate with management on policies and procedures as they relate to regulatory expectations.

Responsibilities

  • Plan and manage large-scale initiatives to ensure timely and accurate completion of program objectives
  • Assists in the identification, implementation, and maintenance of the organization’s compliance, HIPAA and privacy policies and procedures
  • Assist in ongoing compliance monitoring activities to ensure adherence to compliance, HIPAA and privacy policies and procedures
  • Manage the investigation and remediation of any suspected violations of HIPAA requirements
  • Research and assist on Federal and State regulatory requests or potential issues of non-compliance
  • Participate in DMAS and other regulatory audits, meetings and initiatives
  • Facilitate tracking, resolution and response of any DMAS requests, inquiries or MCO improvement/corrective action plans
  • Develop, implement and maintain a system to track and monitor compliance of regulatory deliverables, including reporting, requests and requirements
  • Provide oversight to the Policy Committee and operation of the Policy Manager system
  • Works with Compliance Manager to ensure the organization maintains appropriate privacy and confidentiality consent/ authorization forms, notices and materials reflecting federal requirements
  • Provides or assists in providing employee training on compliance related topics, policies or procedures
  • Participates in the development, implementation, tracking and monitoring of all business associate agreements to ensure that all HIPAA/Privacy concerns, requirements, and responsibilities are addressed
  • Assist in the development and submission of reports/reviews required for state or federal regulatory agencies
  • Travels and represents Virginia Premier at Provider Education Meetings and other provider community engagements/activities
  • Establishes and maintains a mechanism to track access to protected health information
  • Creates, facilitates, and promotes activities to foster information compliance awareness within the organization and related entities
  • Initiates, leads or participates in compliance-related or organization-wide research projects and initiatives
  • Works with the organization personnel involved with any aspect of release of protected health information, to ensure full coordination and cooperation under the organization’s policies and procedures and legal requirements
  • Maintains current knowledge of applicable federal and state privacy laws and accreditation standards, and monitors advancements in information privacy technologies to ensure organizational adaptation and compliance

Qualifications

MINIMUM EDUCATION REQUIREMENTS

 

  • College degree required, experience replacement acceptable
  • Familiarity with health care legislation and standards for the protection of health information and patient privacy preferred

WORK BACKGROUND/EXPERIENCE

 

  • Education and experience relative to the size and scope of the organization
  • 1 – 3 years’ compliance experience required.  Managed Care experience preferred
  • Demonstrated skills in collaboration, teamwork, and problem solving to achieve goals
  • Demonstrated skills in verbal and written communication

 PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

 

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