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Compliance Specialist - CFHP

Job Description

POSITION SUMMARY/RESPONSIBILITIES
The Compliance & Regulatory Specialist is responsible for assisting in the oversight and execution of compliance in the health plan's operational areas, including delegated operational activities and regulatory reporting. The candidate must be familiar with current Texas Medicaid regulations, the Texas Department of Health and Human Services, Texas Department of Insurance (TDI) regulations, the Office of Inspector General (OIG) Compliance Plan, the Centers for Medicare and Medicaid Services (CMS) and should also be familiar with health plan documents such as Summaries of Benefits and Coverage, Schedules of Benefits and Certificates of Coverage. This position will coordinate and facilitate the execution of the company's regulatory deliverables. The Compliance & Regulatory Specialist will assist with the interpretation of and/or execution of changes in regulations and guidelines, including HIPAA. This position will need to build key relationships with regulatory agencies and internally to facilitate improved interaction, transparency and accountability

Job Requirements


A bachelor's degree in business administration, public administration, health care administration or a related field is desired but will accept experience in lieu of education. Proficiency in Microsoft Office applications.

Job Snapshot

Location US-TX-San Antonio
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care
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Company Overview

University Health System

University Hospital is the only pediatric trauma center for San Antonio and South Texas. The trauma team at University Hospital is recognized for its expertise in treating serious injuries and burns in children by the American College of Surgeons (ACS).

Contact Information

US-TX-San Antonio

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Snapshot
University Health System
Company:
US-TX-San Antonio
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

POSITION SUMMARY/RESPONSIBILITIES
The Compliance & Regulatory Specialist is responsible for assisting in the oversight and execution of compliance in the health plan's operational areas, including delegated operational activities and regulatory reporting. The candidate must be familiar with current Texas Medicaid regulations, the Texas Department of Health and Human Services, Texas Department of Insurance (TDI) regulations, the Office of Inspector General (OIG) Compliance Plan, the Centers for Medicare and Medicaid Services (CMS) and should also be familiar with health plan documents such as Summaries of Benefits and Coverage, Schedules of Benefits and Certificates of Coverage. This position will coordinate and facilitate the execution of the company's regulatory deliverables. The Compliance & Regulatory Specialist will assist with the interpretation of and/or execution of changes in regulations and guidelines, including HIPAA. This position will need to build key relationships with regulatory agencies and internally to facilitate improved interaction, transparency and accountability

Job Requirements


A bachelor's degree in business administration, public administration, health care administration or a related field is desired but will accept experience in lieu of education. Proficiency in Microsoft Office applications.

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