Health Plan Compliance Specialist (Remote - PST Hours) at Pair Team

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Full Time

Start Date

Immediate

Expiry Date

29 Dec, 25

Salary

75000.0

Posted On

30 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Project Management, Quality Assurance, Compliance, Operations, Google Workspace, Data Analytics, Reporting Tools, Organizational Skills, Attention To Detail, Critical Thinking, Problem Solving, Stakeholder Engagement, Documentation Management, Audit Completion, Workflow Management, Training Synthesis

Industry

Hospitals and Health Care

Description

About Pair Team At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve. We’re building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support. Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients. We’re one of the largest Enhanced Care Management providers in California and are on track to build the nation’s largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions. At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare. Our Values Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection. Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness. Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo. Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent. Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others. In the News Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most TechCrunch: Building for Medicaid’s regulatory moment with Neil Batlivala from Pair Team Axios: Pair Team collects $9M for Medicaid-based care About the Opportunity As the Quality and Compliance Lead, you will play a critical role in supporting our Operations team in ensuring all Plan requirements and quality metrics are met through auditing, documentation upkeep, and timely submission of regulatory reporting. Additionally, the Quality and Compliance Lead will play an essential role in the maintenance of our in person encounter program. You will own completing and communicating internal audit results, executing on multiple compliance projects at any given time, and proactively suggesting improvements to our operational processes. What You’ll Do Own the completion of internal audits to confirm operations are meeting plan requirements and internal quality metrics Maintain and update internal documentation (e.g., SOPs) to ensure our teams have the most accurate and current information Attend virtual trainings and webinars and synthesize key learnings for internal stakeholders Support submitting monthly/quarterly reporting reporting accurately and on time Independently complete multiple projects simultaneously, demonstrating strong organization and ability to meet critical deadlines Support other ad hoc operational needs, such as gathering supporting documentation or assisting with plan-specific requests What You’ll Need At least 2 years of experience in project management, quality, compliance, or operations Proficiency with Google Workspace (Docs, Sheets, Drive) Experience using Looker or similar data analytics/reporting tools Ability to design organized, easy-to-use trackers and effectively manage workflows in Asana or other similar project management tools Strong organizational skills with proven ability to balance competing priorities and deadlines Meticulous attention to detail with a commitment to accuracy Strong critical thinking and problem-solving skills; able to navigate ambiguity with resourcefulness Confidence in engaging stakeholders by asking clarifying questions during webinars, trainings, and meetings Because We Value You: Competitive salary: $70,000 - 75,000 (depending on experience) Flexible vacation policy – take the time you need to recharge Comprehensive health, vision & dental insurance 401k through Guideline Work entirely from the comfort of your own home Monthly $100 work from home expense stipend We provide the equipment needed for the role Opportunity for rapid career progression with plenty of room for personal growth! Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law. Pair Team participates in E-Verify to verify employment eligibility for new hires. Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use. We do not conduct any TA business outside of our @pairteam.com emails. If you’re ever concerned about spam or fraudulent activity, please reach out to recruiting@pairteam.com. Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!

Responsibilities

The Quality and Compliance Lead will ensure that all Plan requirements and quality metrics are met through auditing and documentation upkeep. This role involves completing internal audits, maintaining documentation, and supporting regulatory reporting.