Sr. 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 Sr. Compliance Specialist provides compliance support with federal and state regulatory requirements; Assists with ensuring Community Health Choice (CHC) complies with industry specifications, standards, regulations, and laws. Reviews operational practices, creates and enforces compliance plans, and performs regulatory risk management.
- Bachelor's degree in healthcare administration, public policy, business or closely related field;
- Certified in Healthcare Compliance (CHC) or able to obtain within 6 months of hire.
- Five years of professional work experience in audit, compliance and regulatory healthcare with experience leading projects
- Microsoft Office (MS Word, MS Excel, MS Access, and Outlook).
- Ability to summarize technical information and provide regulatory guidance through review, interpretation and implementation of state and federal regulations.
- Excellent administrative and organization skills with strong project management skills to meet timelines and measures of success for implementing compliance projects.
- Ability to excel in ambiguous situations, to plan, prioritize, and organize diversified workload.
- Strong written and verbal communications skills with proven success in proactive problem-solving skills.
- Ability to work directly with highly confidential and sensitive information and deal with a diverse group of internal and external contacts at all levels.
- 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.