Healthcare Compliance Specialist

ADP, Inc.; Pasadena (CA); On-site; USD 71,000 - 78,000; Full time

Job summary

Imperial Health Plan in Pasadena, CA seeks a Compliance Analyst to oversee CMS regulatory compliance, FWA prevention, and audits across the organization and FDRs. This role coordinates internal monitoring, training, and reporting to compliance committees.

You will review CMS and state requirements, perform CMS data checks, and help prepare site visit materials while maintaining confidentiality and HIPAA compliance.

Qualifications

• Bachelor's degree preferred and/or 3 to 5 years of related work experience in a health plan and/or healthcare setting.
• Required: 2 years of healthcare compliance experience or CMS/state regulatory agency experience.
• Required: 2 years of experience with regulatory requirements.
• High school graduate or equivalent.

Responsibilities

• Coordinate the compliance oversight activities to meet CMS requirements.
• Report to compliance committees and external oversight entities.
• Review regulatory communications and implement changes as needed.
• Perform internal monitoring and audits of CMS program requirements.
• Prepare CMS and state reporting submissions.
• Assist regulatory site visits and reviews.

Skills

CMS knowledge

Regulatory knowledge

Communication skills

Independent work

Education

Bachelor's degree preferred

High school diploma or equivalent

Tools

MS Office

Job description

Imperial Health Plan in Pasadena, CA seeks a Compliance Analyst to oversee CMS regulatory compliance, FWA prevention, and audits across the organization and FDRs. This role coordinates internal monitoring, training, and reporting to compliance committees.

You will review CMS and state requirements, perform CMS data checks, and help prepare site visit materials while maintaining confidentiality and HIPAA compliance.