Compliance Specialist

🕒 vor 19 Tagen

🌵 Arizona, California, +9 weitere Bundesländer – Remote

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💵 $85.000 - $105.000 / Jahr

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

🚔 Compliance

👻 Geisterscore 11%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Vynca

Vynca

51 - 200 Mitarbeiter

Gegründet 2014

💼 Beratung

⚕️ Krankenversicherung

🏥 Gesundheitswesen

Consulting • Healthcare Insurance • Healthcare

Vynca ist ein Gesundheitsunternehmen, das sich auf Palliativpflege für Patienten mit schweren Erkrankungen spezialisiert hat. Die Organisation konzentriert sich auf die Verbesserung des Pflegemanagements durch Unterstützung, die Schmerztherapie, psychologische Beratung, spirituelle Unterstützung und Vorausplanung der Pflege umfasst. Vynca zielt darauf ab, Patienten bei der Bewältigung chronischer Erkrankungen und komplexer Pflege zu helfen, indem sichergestellt wird, dass sie umfassende Unterstützung von einem engagierten Team von Gesundheitsfachleuten erhalten, sowohl persönlich als auch virtuell. Die Dienstleistungen werden häufig von großen Versicherungsgesellschaften abgedeckt, wodurch wesentliche Pflege direkt zu den Patienten nach Hause gebracht wird oder über Telemedizin-Fähigkeiten bereitgestellt werden.

Beschreibung

• Support the design, implementation, and ongoing maintenance of the healthcare compliance program • Assist in operationalizing the seven elements of an effective compliance program • Advise internal stakeholders on compliance-related questions and translate regulatory requirements into actionable practices • Support compliance and quality oversight for Enhanced Care Management and Palliative Care programs • Monitor regulatory and contractual requirements and evolving guidance • Conduct audits, monitoring, QAPI activities, metric tracking, trend analysis, and corrective action planning • Collaborate cross-functionally to address compliance risks, support audit readiness, and integrate standards into workflows • Monitor federal and state healthcare laws and regulations, including Anti-Kickback Statute, Stark Law, False Claims Act, and HIPAA • Track DOJ/OIG enforcement actions, advisory opinions, fraud alerts, and compliance guidance • Conduct compliance risk assessments and identify, document, and address fraud, waste, and abuse risks • Support regulatory change management and monitor requirements for potential new markets • Assist with compliance audits, monitoring activities, reviews, and internal investigations • Coordinate responses to compliance inquiries, audits, and regulatory requests • Maintain investigation, audit, and other audit-ready documentation • Assist with compliance training and education programs • Promote compliance reporting mechanisms and non-retaliation standards • Draft compliance communications, guidance documents, and policy updates • Collaborate with internal departments to streamline workflows and improve regulatory preparedness • Stay informed on state and federal regulatory requirements • Support ad hoc compliance and quality initiatives

🎯 Anforderungen

• Bachelor’s degree in Healthcare Administration, Compliance, Legal Studies, Business, or a related field, OR equivalent healthcare compliance experience • 2+ years of experience in healthcare compliance, regulatory affairs, audit, or a related role • Working knowledge of federal and state healthcare compliance laws and regulations • Familiarity with healthcare enforcement trends and OIG/DOJ Compliance Program Guidance and enforcement priorities • Experience supporting QAPI initiatives, audits, or quality monitoring activities • Strong analytical, organizational, and documentation skills • Strong understanding of healthcare compliance and regulatory frameworks • Ability to analyze regulations and translate them into practical guidance • High ethical standards and sound judgment • Excellent written and verbal communication skills • Detail-oriented with strong follow-through • Ability to assess operational compliance gaps and make risk-based decisions • Applicants must be based in Arizona, California, Colorado, Florida, Georgia, Illinois, Nevada, North Carolina, Oregon, Texas, Utah, or Washington • Legally authorized to work in the United States • Background check, potentially including a drug test or other health screenings, required prior to employment • E-Verify identity and work eligibility verification upon hire • Influenza vaccination required for patient-, client-, or customer-facing roles • Preferred: Certification in Healthcare Compliance (CHC) or similar compliance certification • Preferred: Experience supporting compliance audits, investigations, or regulatory examinations • Preferred: Knowledge of CMS regulations and reimbursement compliance • Preferred: Experience with ECM, Palliative Care, or similar care management models within Medicaid or managed care environments • Preferred: Knowledge of federal and state telehealth and digital health regulations • Preferred: Experience supporting compliance programs for high-growth, multi-state healthcare organizations • Preferred: Knowledge of digital health regulatory considerations, including data privacy and remote patient monitoring

🏖️ Vorteile

• Medical, dental, and vision insurance • Income protection benefits • Flexible PTO • Company holidays • 401k • Other wellness benefits • Mileage reimbursement for field roles per IRS guidelines

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