Medicare Compliance Analyst II or III

Cambia Health Solutions, Inc.; Utah; Remote; USD 75,000 - 103,000; Full time

Job summary

Join a forward-thinking company as a Medicare Compliance Analyst, where you will play a critical role in ensuring compliance and improving health care systems. This position offers the chance to work collaboratively with a dedicated team, implementing effective compliance programs that prevent and correct violations of laws and regulations. You will engage in various activities including risk assessments, audits, and training, all aimed at creating a sustainable health care system. With a commitment to innovation and a supportive work environment, this role provides an excellent opportunity to grow your career while making a meaningful impact on people's lives.

Benefits

Medical, dental, and vision coverage

Annual employer contribution to health savings account

Generous paid time off

401(k) with company match

Paid parental time off

Wellness programs

Employee Assistance Fund

Commute and parking benefits

Qualifications

• 5+ years of compliance experience in a health care environment preferred.
• Strong project management skills and ability to manage multiple priorities.

Responsibilities

• Design and implement compliance programs to prevent and correct violations.
• Conduct audits, risk assessments, and training sessions.

Skills

Compliance Program Management

Project Management

Written and Oral Communication

Research and Analytics

Legal Research

Decision-Making

Office Software Proficiency

Organizational Agility

Risk Assessment

Training and Monitoring

Education

Bachelor's Degree

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Microsoft Visio

Job description

Medicare Compliance Analyst II or III

Medicare Compliance Analyst II or III

Apply locations: Portland, OR; Salt Lake City, UT; Medford, OR; Coeur d'Alene, ID; Beaverton, OR

Time type: Full time

Posted on: Posted 2 Days Ago

Job requisition id: R-5714

Work from Home within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia’s dedicated team of Medicare Compliance Analysts is living our mission to make health care easier and lives better. As a member of the Compliance team, our Medicare Compliance Analysts are responsible to deliver an effective compliance program. They design, implement, deliver, measure and refine activities and controls to prevent, detect and correct violations of state, federal and other laws. Duties may include, but are not limited to, risk assessment, training, monitoring, auditing, external audit coordination, investigation, root cause analysis, regulatory implementation, control assessment, reporting, and corrective actions – all in service of creating an economically sustainable health care system.

Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

Compliance Analyst II would have a Bachelor’s degree or equivalent experience; 5 years of compliance experience or equivalent related experience, with experience in a health care or Medicare-regulated environment preferred.

Compliance Analyst III would have at least a Bachelor’s degree or equivalent experience; 8 years of compliance experience or equivalent related experience, with experience in a health care or Medicare-regulated environment or ACA-regulated environment preferred.

Skills and Attributes:

• Proven ability to deliver effective Core Compliance activities, including monitoring, auditing, root cause analyses, and corrective actions.
• Skilled in project management and delivery including proven ability to initiate and manage multiple projects and priorities.
• Excellent written and oral communication and presentation skills.
• Excellent research and analytics skills, with proven ability to distill actionable, practical advice from diverse sources and opinions. Legal research skills preferred.
• Proven ability to influence effectively at all levels of the organization.
• Excellent independent judgment and decision-making skills.
• PC literate with office computer software – Word, Excel, PowerPoint, Outlook, Visio, etc.
• Discretion and confidentiality.
• Agile, with high learning velocity.
• Demonstrated fluency in organizational agility: knowledgeable how organizations work and how to get things done through formal and informal channels.
• Practical familiarity with legal requirements relating to assigned compliance program, or for new hires, practical familiarity with analogous legal requirements.
• Demonstrated mastery of at least four Compliance functions, to include the core competencies: risk assessments, training, policies and procedures, monitoring, auditing, external audit coordination, control assessments, reporting, corrective actions, implementation oversight, and ability to perform those compliance functions effectively within that compliance program; or if assigned to a specialized function (e.g. FDR/DDE Compliance, Marketing Materials Review, Data Validations), mastery of all competencies related to that specialized function.
• Demonstrated ability to handle successfully the most complex, most difficult matters end-to-end.
• Demonstrated ability to drive success with the most challenging and/or most elevated partners.

Additional Minimum Requirements (Compliance Analyst III)

• Demonstrated mastery of legal requirements relating to assigned compliance program; or for new hires, demonstrated mastery of analogous legal requirements.
• Demonstrated mastery of at least 6 core compliance functions, including the core competencies and ability to deftly perform all compliance functions relating to assigned compliance program as needed.
• Demonstrated excellence in building effective relationships at all levels of the organization; influencing decision-making; effectively framing issues and dialogues; and driving successful outcomes.
• Demonstrated, end-to-end operational knowledge relating to assigned compliance program.
• Demonstrated peer mentoring and departmental leadership.

What You Will Do at Cambia:

• Overall responsibilities include specific and/or portions of the following functions that relate to an effective compliance program utilizing as a basis the seven elements of compliance.
• Duties include aspects of the preparation, planning, coordination, project management, submission, administration, monitoring and auditing of the Cambia compliance program which serves to oversee activities related to requirements, laws and regulations to prevent, detect and remediate compliance issues of the company.
• Responsibility for producing and maintaining policies and desk manuals for position.
• Works as a team with other staff members assigned in either a supporting or leading role.
• Participating in the annual risk assessment process.
• Ensuring materials, reports, and other documents are written in an understandable and concise style.
• Project management and implementation.
• Participating, supporting and serving in regular meetings, including divisional and cross-divisional committees as needed.
• Core Competencies: risk assessments, training, policies and procedures, training, monitoring, auditing, root cause analysis, and corrective actions.
• Additional Competencies: external audit coordination, implementations, control assessments, delegation oversight, data validation, marketing material oversight, DDE/FDR oversight.

Work Environment

• Travel rarely required, locally or out of state.
• May be required to work outside normal hours.

The expected hiring range for a Compliance Analyst II is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure/certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00.

The expected hiring range for a Compliance Analyst III is $91,800.00 - $123,100.00 depending on skills, experience, education, and training; relevant licensure/certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this role is $86,000.00 to $141,000.00.

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About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [e-mail].

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

About Us

Everyone is a health care consumer deserving of a simpler, more personalized experience. Cambia is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit BlueCross and BlueShield licensed health plans serving over 3 million Americans.

Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices.

Interested in driving accessibility, affordability and quality health care for real people? Apply to any of our open jobs or join the Twitter conversation @Cambia.