Senior Compliance Advisor

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Senior Compliance Advisor, State Programs
DUTIES: Along with the Compliance Officer, Privacy & Information Security Officer, and the Compliance Program Manager, will serve as the focal point for all Medi-Cal, Covered California and Healthy Families compliance activities. Coordinates and communicates all assigned state program compliance activities internally and with firm's contracted provider network; ensures that firm are and its subcontracted provider network is compliant with all state regulatory requirements. Along with the Compliance Officer, this individual is firm's liaison with DHCS and DMHC and other state agencies concerning firm's Medi-Cal products. Ensuring staff are aware of state reporting requirements and reports are submitted to state agencies identifying internal areas for improvement. Responsible for performing internal audits, monitors implementation of corrective measures, and interpretation of DHCS, DMHC and NCQA standards. Responsible for interpreting legislation, state and federal laws and providing guidance to firm staff and contracted providers.

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