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CX Business Compliance Liaison

Job not on LinkedIn

đŸ”„ 5 minutes ago

đŸ‡ș🇾 United States – Remote

đŸ’” $84.8k - $121.1k / year

⏰ Full Time

🟠 Senior

🔮 Lead

🚔 Compliance

Where this job comes from

Posted on Gainwell Technologies's careers page, not through a job board

First seen by Remote Rocketship 5 minutes ago

Logo of Gainwell Technologies

Gainwell Technologies

10,000+ employees

đŸ’Œ Consulting

📩 Logistics

⚕ Healthcare Insurance

💰 Grant on 2023-06

Consulting ‱ Logistics ‱ Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

‱ Support the Director of CX Business Compliance in translating approved requirements into consistent, evidence-based practices across Customer Experience accounts ‱ Provide day-to-day compliance oversight, consultative guidance, escalation coordination, reporting, and implementation support for member and provider account access, provider EFT, and portal administrator changes ‱ Provide functional oversight of verification-review activities performed by Verification Specialists and Senior Verification Specialists ‱ Monitor adherence to approved requirements, identify control gaps and recurring issues, provide compliance guidance, and escalate findings ‱ Coordinate reviews of account work and independent quality reassessments ‱ Support audit-the-auditor reviews, sampling, calibration, root-cause analysis, and corrective-action validation ‱ Monitor authentication, identity and representative authority validation, trusted contact sources, outbound verification, approved scripts, and recording requirements ‱ Serve as an escalation contact for complex, disputed, incomplete, or high-risk matters, including potential fraud, privacy, or security concerns ‱ Partner with Privacy, Security, Legal, Risk and Compliance, Operations, Quality, Technology, Training, implementation teams, and account leadership ‱ Support quality monitoring and secret shopper programs, communicate findings, coordinate corrective actions, and track recurring issues through resolution ‱ Draft and maintain policies, SOPs, scripts, checklists, and work aids ‱ Coordinate role-based training, knowledge checks, access requirements, refresher training, and production-readiness activities ‱ Support new-account implementations by aligning procedures, controls, training, reporting, escalation paths, and required approvals ‱ Gather and validate compliance data, report trends, risks, corrective-action status, and readiness gaps, and maintain secure records and audit trails ‱ Provide backup support to maintain CX Business Compliance activities and document actions and handoffs

🎯 Requirements

‱ Bachelor's degree or an equivalent combination of education and relevant experience ‱ Nine or more years of experience in healthcare operations, compliance, privacy, quality assurance, risk management, or a related area ‱ Experience working in a HIPAA-regulated environment and applying privacy, confidentiality, and information-handling requirements ‱ Experience reviewing business processes, documentation, or operational practices to identify compliance gaps ‱ Experience writing, developing, and maintaining policies, procedures, SOPs, or other controlled documentation ‱ Experience translating regulatory, contractual, or company requirements into practical business processes and controls ‱ Project management experience coordinating initiatives, priorities, and issue resolution across multiple teams or business areas ‱ Experience analyzing findings, identifying trends or root causes, tracking corrective actions, and communicating risks and recommendations to business leaders ‱ Proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint ‱ Experience in Medicaid, healthcare compliance, privacy, provider operations, or member operations ‱ Experience supporting compliance monitoring, quality reviews, audits, corrective-action programs, or process improvement initiatives across multiple accounts or business areas ‱ Experience supporting new implementations, operational readiness, policy or SOP governance, training, or leadership reporting ‱ Familiarity with CXone, Motif, or similar case management, interaction review, verification, or reporting tools ‱ Compliance, privacy, security, or project management certification such as IAPP CIPP, CIPM, CIPT, PMP, CISA, CISM, or comparable certification

đŸ–ïž Benefits

‱ Work flexibility ‱ Learning and career development ‱ Up to 10% travel opportunity ‱ Flexible vacation policy ‱ 401(k) employer match ‱ Comprehensive health benefits ‱ Educational assistance ‱ Leadership and technical development academies

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