Compliance Administrator

Job Description

Job Description

Must be able to work onsite up to 3 days per week

GENERALFUNCTION

• The Administrator-Compliance (Programs)is responsible for preparing, researching, and completing the regulatory reports, amendment filings, and business partners/carrier reporting requirements. This includes operational processes and programs to assure compliance with various regulatory requirements such as Medicare Advantage (MA),
• Department of Managed Health Care (DMHC), Department of Insurance(DOI), and Employee Retirement Income Security Act (ERISA).
• Compares and evaluates possible courses of action and makes recommendations to the Compliance Manager or leadership team. Assists the Compliance Manager in assuring compliance with policies, procedures, and requirements set by state and federal agencies. Modifies policies and procedures as necessary.

MAJORDUTIESANDRESPONSIBILITIES

• Thoroughly prepares,researches, and completes DMHC reports and amendment filings, business partners/carrier reporting requirements, and any other requirements set by state and federal agencies. Reviews related regulations and performs analysis to assure all requirements are met and filed within the deadline.
• Thoroughly and timely tracks reporting deadlines by month and logsallin-process and completed reports.
• Prepares and/or oversees internal claims and quality management/utilization management audit results and findings in collaboration with the Manager-Compliance,Claims Manager/Team Leader, and Quality Management VP/Team Leader and Clinical Director.
• Prepares documents to be presented to the Quality Management Committee, Public Policy Committee, Board of Directors, and Management Team.
• Provides oversight with the compliance work plan and monitoring functions and activities including risk assessment.
• Assists with the Language Assistance Program (LAP) activities such as stafflanguage fluency assessment, monitoring the enrollee assessment report, Customer Service Department calllog and preparing andmai
• Prepares reports, maintains files, and communicates the data & information associated with local, state, and federal regulatory guidelines for the network including those setforth by EPA, StateEPA, CalEPA, CaliforniaCUPAs and other state and local environmental regulatory agencies. Supports compliance with federal, state, and local environmental laws
• Ability to work effectively with regulatory agencies is required while communicating with facilities throughout U.S. and Canada regarding permits, inspections, and compliance requirements
• Maintain general and up to date knowledge of fire protection systems and associated general regulatory compliance requirements
• Acquire approval for environmental compliance related payables and track invoices & check requests
• Manage Water Discharge Monitoring Reports
• General knowledge of SPCC plans and Storm water management plans as they relate to our operations
• Familiarity with the Clean Air Actasitrelatesto our operations
• Familiarity with EPCRA requirements as they relate to our operations
• General knowledge of California special wastes as they relate to our operations
• General understanding of Environmental Management Systems
• Maintain document files pertaining to audits & observations of workforce performance with regard to environmental compliance
• Through observation of documents such as reports, permits, & inspection forms, be able to detect potential environmental compliance problems of an accounting, bookkeeping, and clerical nature.
• Facilitate, arrange, and conduct environmental related training and orientation as needed
• Track information on energy and resource-efficient projects & programs. This could include energy conservation programs and future LEED certifications

About company - Since its founded in 1996, CTC has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, CTC has a team of over 2,000 experts worldwide. We empower more than 100 organizations to tackle complex challenges and transform them into sustainable competitive strengths--driving innovation, efficiency, and growth every step of the way. Our strengths have always been Commitment to Customer, Commitment to Colleagues, and Commitment to Community (CTC).

Company Description

About company - Since its founded in 1996, CTC has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, CTC has a team of over 2,000 experts worldwide. We empower more than 100 organizations to tackle complex challenges and transform them into sustainable competitive strengths--driving innovation, efficiency, and growth every step of the way. Our strengths have always been Commitment to Customer, Commitment to Colleagues, and Commitment to Community (CTC).