Research compliance program benchmarks and requirements.
Write/maintain compliance policies and program descriptions.
Assist compliance vendor oversight activities.
SmithRx is a rapidly growing, venture-backed Health-Tech company aiming to disrupt the PBM sector. They have a mission-driven and collaborative culture that inspires employees to transform the U.S. healthcare system.
Investigating alleged violations of Illinois Shines program requirements.
Drafting letters regarding program violations and ensuring compliance.
Identifying trends in consumer complaints and recommending proactive measures.
Energy Solutions focuses on delivering large-scale energy, carbon, and water-use savings through market-based programs. Since 1995, they've offered performance-based solutions for their utility, government, and institutional customers.
Lead our Eligibility team to ensure our participants maintain eligibility for PACE services.
Proactively identify and mitigate risks pertaining to participant eligibility.
Oversee participant demographic, eligibility and enrollment data integrity across Welbe systems.
WelbeHealth's interdisciplinary team provides all-inclusive care to vulnerable seniors. The company is rapidly expanding and has an encouraging and loving environment where every person feels uniquely cared for.
Support internal and external audits by helping coordinate documentation, timelines, and follow up items
Collaborate with cross functional partners to gather information and support compliance reviews
Monitor daily, weekly, and monthly quality and oversight reports to ensure regulatory and internal deadlines are met
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier. They partner with over 450 companies and brands you use and know like Microsoft, Target, and Delta Airlines, providing care for 10 million people.
Ensure adherence to regulations and contractual obligations.
Develop and update compliance policies and SOPs.
Conduct internal compliance audits and report findings.
Equip is a virtual, evidence-based eating disorder treatment program. They aim to ensure that everyone with an eating disorder can access effective treatment, operating in all 50 states and partnered with most major health insurance plans. Since its founding in 2019, Equip has maintained a fully virtual environment.
Acting as first point of contact for all inbound compliance queries, routing matters as necessary to appropriate team members and tracking completion
Supporting and coordinating recurring compliance tasks that help mitigate regulatory risk to the company
Assisting with preparation and submission of routing regulatory filings such as state registrations and annual reports
Virta Health is dedicated to reversing metabolic disease in one billion people through personalized nutrition and virtual care. They have raised over $350 million and partner with health plans, employers, and government organizations.
Leads Government Programs support for Exchange business functions.
Partners with SMEs to analyze regulatory changes and determine implications.
Provides key insights on Exchange functions using data analysis.
Judi Health is an enterprise health technology company that provides solutions for employers and health plans. They help rebuild trust in healthcare in the U.S. and deploy the infrastructure needed for care.
Administer health, welfare, and retirement benefits programs, handling processes, billing, deductions, and leave management.
Ensure compliance with regulations (e.g. ERISA, the Affordable Care Act, etc.) and mandatory notices.
Provide clear communication to employees and management about benefit program features, plans, and options.
Concorde Career Colleges is committed to a policy of Equal Employment Opportunity. They will not discriminate against an applicant or employee based on any legally protected characteristic recognized under applicable federal, state, or local law.
Provide centralized, remote support to the Department of Veterans Affairs (VA) Dental Pilot Program.
Coordinate meetings, training sessions, and conferences; plan and schedule mobile clinic operations where applicable.
Identify inefficiencies and bottlenecks; document process updates; support implementation of quality control measures.
International SOS Government Medical Services, Inc. delivers customized medical and security risk management and wellbeing solutions to enable our clients to operate safely and effectively in environments far from home. With 12,000 staff (including 5,200 medical and behavioral health providers) they provide healthcare support to Government defense and civil agencies and government contractors.
Responsible for ensuring compliance requirements are established, implemented and understood by appropriate audiences.
Develops basic to moderately complex solutions for compliance issues/problems and review and determine price reasonableness based on policies, procedures, and Federal Acquisition Regulations (FAR).
Conducts regular and periodic reviews of existing procedures and other documents and assists in the development of communication plans for implementing new or revised policies, procedures or practices.
Savannah River Mission Completion (SRMC) manages the Department of Energy’s Savannah River Site’s Liquid Waste operations contract. Located in Aiken, South Carolina, SRMC is a limited liability company formed by nuclear operations and environmental remediation global leaders BWXT, Amentum, and Fluor.
Responsible for payroll deductions, including payroll taxes, health and welfare benefit deductions, and retirement administration.
Serves as a subject matter expert for payroll tax compliance, supports audits, and investigations.
Partners with HR, Legal, Finance, Labor Relations and Payroll Operations to mitigate compliance risk.
Lucile Packard Children’s Hospital Stanford combines advanced technologies and breakthrough discoveries with family-centered care. They provide caregivers with continuing education and state-of-the-art facilities. They are committed to healing humanity, one child and family at a time, and they need caring, committed people on their team.
Provide regulatory compliance risk assessment and consultation.
Assist financial services clients in strengthening their compliance management systems.
Conduct regulatory compliance testing for federal consumer compliance regulations.
Wipfli provides accounting and consulting services. Their people are the core of their business, and they focus on relationships while encouraging individuals to follow their own path.
Lead day-to-day census, enrollment, eligibility, and Medicaid re-eligibility operations.
Develop, maintain, and enforce department policies, procedures, workflows, and monitoring routines.
Supervise, mentor, and develop staff while setting clear expectations and maintaining accountability for performance and quality.
Habitat Health aims to help older adults experience an independent and joyful aging journey. They provide clinical and social care through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with healthcare partners like Kaiser Permanente.
Take the lead on complex regulatory projects that drive strategic decisions across key states.
Manage compliance research, solve challenging regulatory issues, and partner with leadership to ensure the company stays ahead of evolving laws.
Influence risk mitigation, process improvements, and state-level strategies, making a real impact on the business.
Liberty Mutual strives to craft a workplace where every employee is valued and supported. They achieve this by prioritizing a wide range of perspectives, comprehensive benefits, workplace flexibility, professional development, and employee resource groups.
Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies.
Support for the development and deployment of audit procedures applied to payer data sets.
Partner across teams and with payers to resolve data discrepancies.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. They are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
Maintain accurate provider profiles on CAQH, NPPES and any other applicable profiles
Complete credentialing applications to add current and new providers to commercial, Medicaid, and Medicare payers
Expressable is a virtual speech therapy practice with a mission to transform care delivery and expand access to high-quality services. They are passionate advocates of parent-focused intervention, serving thousands of clients since their inception in late 2019.
Design and/or enhance targeted and annual risk assessments.
Construct specific and effective auditing and monitoring workplans based on risks identified.
Analyze compliance outcomes and ensure detected issues are referred for remediation.
SmithRx is a rapidly growing, venture-backed Health-Tech company aiming to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector. With hundreds of thousands of members onboarded, they foster a mission-driven and collaborative culture, dedicated to transforming the U.S. healthcare system.
Ensure pharmacy maintains compliant licenses at federal, state, and local levels.
Manage preparation, submission, and renewal of pharmacy licenses.
Stay abreast of pharmacy regulations, laws, and policies to ensure compliance.
Strive Pharmacy offers personalized pharmaceutical solutions through compounding, addressing limitations of the one-size-fits-all approach. They're dedicated to providing better experiences for customers and clinics, striving to disrupt healthcare with a focus on personalized care and a proactive approach to health.
Oversees the work of Learner Compliancy specialists and supports their development and performance management.
Ensures consistent execution of compliance workflows across all learner populations, including extended-term courses.
Monitors and evaluates team KPIs to ensure compliance targets are met or exceeded.
Nightingale Education Group focuses on higher learning in healthcare professions. They elevate education, health, and employment systems through academic achievement, personal growth, and professional development of learners, alumni, and collaborators, while serving diverse communities.