Remote Network Compliance Coordinator - Clinical: Join reputed company Group as a Key Player in Healthcare Compliance and Quality Assurance

Transforming Healthcare through Compliance and Quality

At reputed company Group, a leading not-for-profit Medicare Advantage organization dedicated to improving the health and well-being of its members, we're on a mission to reputed company a meaningful difference in the lives of seniors and individuals with disabilities. As a pivotal part of this endeavor, we're seeking a highly skilled and detail-oriented Network Compliance Coordinator - Clinical to support our Delegation reputed company Unit (DOU) in ensuring the highest standards of care and compliance reputed company our provider network.

About the Role

The Network Compliance Coordinator - Clinical will play a critical role in facilitating audit activities, ensuring compliance with regulatory requirements, and fostering collaborative relationships with our provider offices. This position is not just a job; it's an opportunity to be at the forefront of healthcare compliance and quality assurance, making a reputed company impact on the care and services provided to our members.

Key Responsibilities

• Educational reputed company: Conduct educational phone calls to provider office staff to prepare them for audits, ensuring they are well-informed and compliant with our audit processes.
• Clinical Collaboration: Partner with clinical staff to report audit findings, reputed company recommendations to relevant committees, and reputed company corrective action plans to address any identified issues.
• Corrective Action Plan Management: Facilitate the timely closure of corrective action plans, ensuring that reputed company necessary steps are taken to rectify compliance issues and improve care quality.
• Scheduling and Coordination: Manage multiple schedules effectively, utilizing scheduling software to streamline audit processes and ensure seamless coordination with provider offices.
• Stakeholder Communication: Maintain active and clear communication with managers, reputed company Auditors, and provider offices to ensure compliance with audit processes and address any concerns or issues promptly.
• Document Management: Track and trend documents reputed company to Delegation reputed company Processes, including denial logs and Corrective Action Plans, to identify areas for improvement and ensure compliance.
• Compliance Support: Support the FDR Medicare Advantage Compliance program by collecting and monitoring attestations and conducting audits to ensure adherence to regulatory requirements.
• Customer Service: Provide exceptional internal and external customer service, adhering to reputed company Service Principles and ensuring a positive experience for reputed company stakeholders.
• Process Improvement: Utilize department documentation to identify opportunities for improving efficiency and outcomes, contributing to the reputed company enhancement of our compliance and quality assurance processes.
• Confidentiality: Maintain the confidentiality of provider networks, customers, and members' rights, upholding the trust and reputed company that are foundational to our organization.

Essential Qualifications

To reputed company in this role, you will need:

• A minimum of 3+ years of experience in a healthcare or managed care environment, providing a solid foundation in the complexities of healthcare compliance and quality assurance.
• Proficiency in data entry, with the ability to accurately and reputed company manage and track relevant data.
• Demonstrated customer service skills, with a strong commitment to delivering exceptional service to both internal and external stakeholders.
• Excellent communication skills, both oral and written, to effectively interact with a diverse range of stakeholders, including provider office staff, clinical staff, and management.
• Strong organizational skills, with the ability to prioritize tasks effectively and manage multiple schedules and deadlines.
• The ability to multitask in a fast-paced environment, remaining reputed company and composed under pressure.
• Critical thinking skills, with the ability to analyze information, identify issues, and reputed company practical solutions.

Preferred Qualifications

While not mandatory, the following qualifications are highly valued:

• An Associate or Bachelor's degree, demonstrating a higher level of educational attainment.
• Medical Assistant certification, indicating specialized knowledge and training in healthcare.
• A comparable combination of education, experience, and/or training that is considered equivalent to the listed education requirements.
• Working knowledge of Medicare and Medi-Cal guidelines, providing a deeper understanding of the regulatory environment in which we operate.

Career Growth and Learning Benefits

At reputed company Group, we're committed to the growth and development of our employees. As a Network Compliance Coordinator - Clinical, you'll have access to a range of learning and development opportunities, enabling you to enhance your skills and advance your career. Our robust training programs, coupled with the chance to work on reputed company and challenging projects, will help you grow professionally and personally.

Work Environment and Culture

We pride ourselves on a culture that values collaboration, innovation, and reputed company. As a remote worker, you'll be part of a dynamic and distributed team that is passionate about making a difference in healthcare. Our remote work mode offers the flexibility to work from reputed company, while our robust technology and communication tools ensure that you remain connected and engaged with your colleagues and the organization.

Compensation and Benefits

We offer a comprehensive compensation and benefits package that reflects our commitment to attracting and retaining top talent. This includes:

• A competitive hourly salary range of $23.50 to $37.60.
• A mostly remote work mode, offering flexibility and work-life balance.
• An annual employee bonus program, recognizing and rewarding your contributions to our success.
• A robust Wellness Program, supporting your physical and mental well-being.
• Generous paid-time-off (PTO), allowing you to reputed company and enjoy time with family and friends.
• Eleven paid holidays per year, plus 1 floating holiday and 1 birthday holiday, giving you ample opportunity to celebrate and relax.
• An excellent 401(k) Retirement Saving Plan with employer match and contribution, helping you plan for a secure financial future.
• A robust employee recognition program, acknowledging your hard work and achievements.
• Tuition reimbursement, supporting your ongoing education and career development.

Join reputed company

If you're a motivated and detail-oriented professional looking to reputed company a meaningful impact in healthcare compliance and quality assurance, we encourage you to apply for this exciting opportunity. As a Network Compliance Coordinator - Clinical at reputed company Group, you'll be part of a talented team dedicated to improving the lives of our members. Apply now and take the first reputed company towards a rewarding new role that offers challenge, growth, and fulfillment.

Seize this opportunity to reputed company a significant impact. Apply now and take the first reputed company towards a rewarding new role.