Senior Compliance Specialist
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
The Senior Compliance Specialist supports the Director of Compliance, Federal Programs by providing compliance support with federal and state regulatory requirements. This position will work directly with highly confidential and sensitive information and deals with a diverse group of internal and external contacts at all levels of the organization. Independent judgment is required to plan, prioritize, and organize diversified workload.
- Bachelor's Degree or four years of experience in lieu of education
- Two years of experience in managed care, preferably in Medicare Advantage and/or Marketplace compliance.
- Strong project management skills
- Proven success in proactive problem solving skills
- Ability to excel in ambiguous situations
- Ability to review, interpret and implement state and federal guidance.
- Ability to summarize technical and regulatory guidance
- Strong written and verbal communications skills
- Ability to work both independently and as a member of a larger team.
Benefits and EEOC
Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
Community is an Equal Opportunity Employer.