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The Analyst III – Compliance Program has expert knowledge and performs key Compliance Program activities of complex difficulty. Team Members in this position are responsible for contributing to and leading in the development and implementation of the Compliance Program through operational processes, special projects, and the seven (7) elements of an effective compliance program, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
Key Responsibilities:
1 Leads the development and implementation of organization-wide project initiatives for the Compliance Department; including but not limited to technical/analytical support, creation of project timelines, identification of project deliverables, and oversight of the overall status of the project.
2. Effectively manage multiple projects concurrently. Provide strategic project management leadership and direction to develop and lead cross-functional work groups to accomplish projects. Provide creative, results driven, and self-motivated solutions to timely execute projects.
3. Lead and ensure project development and prioritizes needs; define project scopes, goals and deliverables. Pro-actively manage projects to successful conclusion and report status utilizing standard tools including project milestones, project plans and reports. Effectively communicate the status of assigned projects to Executive Leadership including risks, issues, barriers identified and recommend solutions.
4. Contribute to internal work plan by identifying areas of non-compliance and developing recommendations and solutions to ensure program effectiveness.
5. Triage complex compliance issues and inquiries from departments and units, understand the underlying intent of the questions and perform necessary research and analysis to provide accurate responses and recommendations. Lead workgroups to ensure adherence with guidance and recommendations.
6. Proactively identify areas of improvement for the Compliance Department and lead the development of performance improvement initiatives.
7. Obtain an understanding of the various systems and data sources utilized by the Plan. Develop tools, templates, and resources to manage projects and identify risks, issues, and barriers. Leads workgroups to ensure compliance and recommended solutions are included in the process and/or operational improvements implemented by the business departments and units.
8. Leads and facilitates compliance program effectiveness through:
a. Proactively identifying policy development and revisions required for the general operation of the Compliance Program and related activities.
b. Develop comprehensive reports to the Governing Board, partnering with peers to ensure all necessary information is communicated to the Governing Board allowing the Board to exercise reasonable oversight of the Compliance Program.
c. Develop Compliance Committee reports which includes ensuring relevant and necessary information is presented to allow the Committee to support and advise the Compliance Program.
d. Develop and collaborate in the Compliance, FWA, and Privacy Training to ensure the staff is knowledgeable of and complies with applicable Federal, State, and industry standards.
e. Develop and lead the Compliance Program Communication Plan and awareness campaigns.
f. Conduct and/or lead complex investigations concerning compliance issues.
g. Develop and monitor program/department dashboards, corrective action plans, and other monitoring activities to ensure risks are mitigated.
9. Lead, facilitate, and participate in relevant committees and work groups; create presentations, prepare reports, data, or other materials for presenting and training.
10. Prepare for and participate in audits; draft audit responses and reports as needed.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
Education & Experience
Key Qualifications
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