Administrative Coordinator - Compliance - Day Shift - Full Time

at  Sharp Healthcare

WEEKEND REQUIREMENTS:

No Weekends

REQUIRED QUALIFICATIONS

• Associate’s Degree Jr. College Degree, or paralegal certificate or equivalent.
• 3 Years in a high level administrative and/or paralegal related work experience in a compliance department, law office, or other similar setting.
• Must have experience reading and interpreting legal and regulatory guidance and requirements.
• Must have experience managing sensitive issues/materials and maintain strict confidentiality; exercising sound judgment.
• Must have experience with managing multiple priorities, handling time-sensitive issues and meet set deadlines.
• Office experience must include: project coordination, record-keeping, and filing; strong phone and email etiquette; use of office equipment such as multiline phones, photocopier, scanner, and fax machine; prepare routine letters and reports, memorandums, meeting minutes and other correspondence.

PREFERRED QUALIFICATIONS

• Bachelor’s Degree in related field.

KNOWLEDGE, SKILLS, AND ABILITIES

• Must possess advanced word processing/computer skills utilizing a variety of software programs including, but not limited to, Microsoft Word, Excel, Outlook, Adobe, PowerPoint and project management software.
• Familiarity with legal terminology related to general legal concepts and specific areas of assignment is preferred.
• Knowledge of health plan operations is preferred.
  Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

WHAT YOU WILL DO

Under minimal supervision, exercises responsibility as administrative coordinator for the Compliance and Regulatory Affairs Department. Reporting to the Director Compliance and Regulatory Affairs, the Administrative Coordinator Compliance is responsible for ongoing projects and providing a variety of administrative support functions for the Director, the Manager Commercial Compliance, the Manager Medicare Compliance, the Lead Oversight & Monitoring, and other departmental personnel as requested. Assigned functions may include but are not limited to coordination and scheduling of delegation oversight audits; compiling, reviewing and submitting regulatory reports; preparation and submission of routine regulatory filings; coordination of external regulatory audits; submission and organization of public records requests; review and completion of subpoenas and other record requests.

ESSENTIAL FUNCTIONS

• Delegation oversightMaintains calendar of delegation oversight activities.Submits record requests to delegated entities. Coordinates review of policies, reports and other documents submitted by delegates in accordance with department guidelines, including review for format, completeness, and timeliness. Follows up with delegate as needed to address incomplete submissions.Escalates complex issues or repeated deficiencies to department leadership.Schedules delegate audits by Plan business owners. Collects audit results for review by applicable Compliance staff.Appropriately screens emails, telephone calls and other communication from delegated entities and Plan business owners.Communicates effectively and professionally with all levels of staff and outside contacts.Responds to inquiries on a variety of matters such as the status of pending audits and other requests that may involve giving factual information regarding health plan and departmental policies and procedures.Maintains confidentiality of material and information handled. Maintains well-organized electronic files of all documents.Updates calendar and other tracking tools to document tasks scheduled and completed, audit findings.Follows up with business owner if notice not received that audit/review is completed.
• Meeting coordinationSchedules and arranges meetings (including conference room), conference calls and other appointments for Director and notifies interested parties. Prepares and distributes meeting materials including agendas, presentations, hand-outs and minutes. Maintains roster of attendees and meeting minutes.Coordinates deliverables for external audits. Maintains files of all documents submitted. Monitors timeliness and completeness of submissions, and promptly notifies Director of any concerns.Schedules conference rooms, webinars, meetings, etc. as required for external audits. Ensures all required and preferred supplies, materials and information are available to auditors.
• Other dutiesParticipates in special projects and other duties as assigned. These may include, but are not limited to, work groups, proposals, and back-up support for other departments.
• Record requestsSubpoenas and other record requestsSorts, prioritizes and distributes mail and faxes for the Compliance Department; attach incoming correspondence to applicable file and related materials as needed for action. Respond and/or refer as needed.Serve as the primary contact at Sharp Health Plan to accept subpoenas for Plan records, and coordinate response. Consult with Compliance Director and/or attorney as needed regarding subpoena responses.
• Regulatory reporting and filingsServes as a designated user in the DMHC (state) and HPMS (federal) online portals, in order to submit and retrieve required documents.Under minimal supervision, prepares and submits routine regulatory filings.Submits quarterly Public Record Act (PRA) requests to DMHC for filings by other health plans. Submits ad hoc PRAs as requested. Reviews, sorts, labels, files and distributes PRAs according to department policy.
• ReportsMaintains and monitors calendar of required regulatory reports. Updates calendar to document completed reports.Sends reminders to business owners to ensure reports are submitted timely.Reviews reports for completion and accuracy. Contacts business owners for corrections as appropriate.Escalates complex issues or repeated deficiencies to department leadership.Submits reports to regulators, or documents submissions by business owners.Updates reporting calendar annually and distributes to business owners for notification and confirmation.Maintains confidentiality of material and information handled. Maintains well-organized electronic files of all documents.