California Licensed Compliance Specialist

Job Summary

A company is looking for a Compliance Specialist II to join their Compliance Department.

Key Responsibilities

• Conducts ongoing reviews and analysis of contractual provisions and regulations
• Researches compliance-related questions and responds to external information requests
• Assists with internal and external audit processes to ensure compliance

Required Qualifications, Training, and Education

• Bachelor's degree in Business, Public Administration, Public Policy, Health Care Planning, or a related field
• Minimum of three years of compliance experience (Master's degree may substitute for two years)
• Experience in a managed care or healthcare environment
• Knowledge of Medi-Cal and Medicare Advantage programs and related regulations
• Experience in audits, monitoring, risk assessment, or delegate oversight