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Compliance Specialist II, South San Francisco, CA


Health Plan of San Mateo

Professional

South San Francisco, CA

January 24, 2017


COMPLIANCE SPECIALIST II

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Compliance Specialist II to gather data for regulatory reports, perform technical analysis, make system enhancements, and develop reports in support of the Compliance Department. This includes conducting analysis for complex projects, developing solutions, and assisting in the coordination and management of projects. The Compliance Specialist II will act as System Administrator of designated Compliance Software to ensure Organizational Compliance. Essential duties & responsibilities will include the following:

  • Analyze and track HPSM operational performance using management specified metrics.
  • Maintain Compliance Software including the configuration of modules and development and update of User Guides.
  • Generate and develop reports to track and monitor compliance activities.
  • Assist in Compliance project management, including analysis of project needs and development of project plans.
  • Prepare and submit regulatory reports.
  • Establish tracking system to ensure timely reporting and maintain documentation of report submission.
  • Assist management in tracking key deliverables related to departmental projects.

Requirements

Education and Experience: Bachelor’s degree in Management Information Systems or related field (preferred) and/or equivalent experience in lieu of a degree on a year for year basis. Three (3) years of experience in healthcare or similar operational area. Managed care background preferred.

Knowledge of: Familiarity with the health care field. Regulatory and/or compliance processes impacting managed health care. Principles and methods of planning, directing, and maintaining compliance with regulatory standards. Principles and practices of managed care health care systems, medical administration and NCQA accreditation standards. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint. MS Access at an advanced level.

Ability to: Understand relational data models, concepts and structure. Utilize strong analytical skills with high attention to detail. Demonstrate excellent problem solving skills. Communicate appropriately, both verbally and in writing. Perform research using legal/regulatory databases or search engines. Set priorities and meet commitments. Effectively manage and prioritize multiple concurrent projects. Work under pressure and within strict time frames. Provide excellent customer service. Identify, analyze, and solve problems and work with teams to problem solve. Participate in teams as a strong team participant. Develop and implement basic project plans with direction and supervision.

Starting Compensation Range: $52,825-$66,000 – depending on experience.

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s coverage in the medical HMO plan and majority of PPO medical cost. Employee pays a small portion of the dependent premiums for medical and dental benefits. Additional HPSM benefits include fully paid vision, life, AD&D, STD, and LTD insurance; 457 Plan in lieu of social security (7.5% of salary/HPSM paid); retirement plan (10% of salary for compensation/HPSM paid); holiday and vacation pay; tuition reimbursement plan; and more.

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: careers@hpsm.org or via fax: (650) 616-8039. File by: Continuous until filled. EOE


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