Compliance Specialist II

Central California Alliance for Health; California (MO); Remote; USD 63,000 - 112,000; Full time

Job summary

Join a leading healthcare organization as a Compliance Specialist II. This remote role involves ensuring adherence to regulations and supporting compliance initiatives. Ideal candidates will have experience in managed care, knowledge of Medi-Cal and Medicare regulations, and strong multitasking skills. The position offers a hybrid work environment and competitive compensation based on location.

Benefits

Medical, Dental, Vision

Paid Time Off and Holidays

Retirement Plans (401(a), 457)

Health and Wellness Programs

Onsite EV Charging Stations

Qualifications

• At least three years of compliance experience; Master's may substitute for two years.
• Equivalent education and experience may be considered.

Responsibilities

• Review and analyze contractual provisions and regulations regularly.
• Assist with audit processes to ensure compliance.
• Coordinate oversight activities for subcontractors.

Skills

Attention to detail

Time management

Multitasking

Education

Bachelor's degree in Business

Public Administration

Healthcare Planning

Job description

Compliance Specialist II

Location: Remote, California

Join the Alliance as a Compliance Specialist in the Compliance Department. This role involves ensuring adherence to relevant regulations and supporting our compliance initiatives.

Responsibilities

1. Review and analyze contractual provisions and regulations regularly.
2. Research staff questions regarding compliance and respond to external requests related to DHCS, DMHC, and CMS requirements.
3. Assist with audit processes to ensure compliance and provide program guidance across all business lines.
4. Coordinate oversight activities for subcontractors to ensure compliance with all requirements.
5. Perform additional duties as assigned.

Team Overview

The Compliance Division safeguards the organization's integrity by interpreting requirements, mitigating risks, and ensuring stakeholders adhere to compliance standards. We conduct audits, monitor internal concerns, and support a culture of compliance internally and externally.

Ideal Candidate

• Experience in managed care or healthcare environments.
• Knowledge of Medi-Cal and Medicare Advantage regulations.
• Experience in audits, monitoring, and delegate oversight.
• Attention to detail and data accuracy.
• Ability to work remotely, self-motivated, and team-connected.
• Excellent multitasking skills in a fast-paced environment.
• Time management skills to meet deadlines.

Qualifications

• Bachelor's degree in Business, Public Administration, Public Policy, Healthcare Planning, or related field, with at least three years of compliance experience (Master’s may substitute for two years).
• Equivalent education and experience may be considered.

Additional Information

• Hybrid work environment; remote interviews via Microsoft Teams.
• Attendance at quarterly events and meetings may be required.
• In-office presence might be needed based on business needs.

Compensation

Range varies by location:

• Zone 1 (Bay Area, Sacramento, Los Angeles, San Diego): $69,937 - $111,904
• Zone 2 (Fresno, Bakersfield, Central Valley, Eastern California, Eureka): $63,645 - $101,837

Benefits

• Medical, Dental, Vision
• Paid Time Off and Holidays
• Retirement Plans (401(a), 457)
• Health and Wellness Programs
• Onsite EV Charging Stations

About Us

We are over 500 dedicated employees committed to accessible, quality healthcare. Join us at the Central California Alliance for Health, serving multiple counties with a culture of respect, diversity, and professionalism. We are an equal opportunity employer and participate in E-Verify. Currently, sponsorship is not available; applicants must be authorized to work in the U.S. full-time without sponsorship.