Delivery You Can Count On
As a member of our Claims Connect team, you'll help process and deliver the claims information Kaiser Permanente's members, providers, regulators, and customers need, and expect, from a world-class health care organization.
Compliance Consultant VLocation: Rancho Cucamonga, CA Additional Locations:
1800 Harrison 1800 Harrison, 1800 Harrison, Oakland,California, 94612
Meridian - Englewood MSSA 9800 S. Meridian Blvd., 9800 S. Meridian Blvd., Englewood,Colorado, 80112 Job Number: 768675 Date posted: 01/31/2019
- Manages, creates, and maintains client relationships.
- In adherence with the KP Compliance Framework, fosters comprehensive compliance management through a series of activities to comply with all applicable regulations and statutes. Activities include: Planning: identifying compliance accountabilities; identifying internal and external resources; developing Compliance, Work, and Audit plans; participating on and may establish compliance-related committees/work groups; and managing external agency relations. Implementing: identifying compliance requirements and conducting related analyses; creating or revising compliance standards, policies, and procedures; developing and/or conducting compliance and ethics training; monitoring compliance adherence; and reporting on compliance efforts and programs. Validating: reviewing compliance programs and content, including designing and conducting risk assessments and/or audits, and investigating instances of reported non-compliance.
- Researches and stays abreast of regulations and statutes. Determines impacts of implementation of new regulations and statutes and required notifications, changes, and training. Communicates required changes, develops tools to assess risks, and leverages existing workgroups/etc. to facilitate required changes. May engage external regulatory and legislative bodies on developing regulations and laws, providing input and representing Kaiser Permanente's interests.
- Minimum twelve (12) years of health care compliance, health care operations (quality, risk, etc.), audit, finance, project management, regulatory or public policy development, investigations, information security, or insurance/health plan governance experience.
- Bachelor's or clinical degree, OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
Licenses, Certifications, Registrations
- Expert knowledge of health care compliance policies, practices and systems.
- Expert knowledge of health care and related compliance issues.
- Develops advanced compliance principles, theories, and concepts.
- Expert knowledge of health care industry practices and standards.
- Ability to draft and revise documents including policies, standards, analyses, and reports.
- Project management skills.
- Must be able to work in a Labor/Management Partnership environment.
- Healthcare and or Health Plan Experience
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
About Insurance & Claims Careers
Careers in Insurance & Claims
Our insurance and claims teams are committed to meeting customer and member expectations when it comes to the timely and accurate processing of claims, while remaining in compliance with federal, state, and local laws, as well as regulations and rules. Make an impact as you contribute to the implementation of contemporary technology in areas such as claims quality, claims operations, business analysis, processing, configuration, reporting, and more.
See What People are Saying About Working at KP
Sep 16, 2018
"Great place to spend a work day"
- Positive Outlook
- Approves of CEO
I have been working at Kaiser Permanente full-time (More than a year)
Friendly professional people who share insights and work together for improvements and success. Excellent pay and good employee recognition programs.Full Review
Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.
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