Compliance Specialist

Compliance Specialist

AllCare Health | Compliance Department | Grants Pass, Oregon

We Are Seeking Qualified Candidates to Join Our Team!

AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options.

Summary

The Compliance Specialist supports AllCare CCO’s Compliance, Community Engagement, Community Benefit, Equity, and Language Access programs to help ensure adherence to applicable rules, regulations, and state and federal contractual requirements.

This position provides program and project support, builds relationships with community partners and stakeholders, assists with monitoring and reporting, and contributes to initiatives that support healthcare transformation and improved community health.

Essential Duties

1. Supports the operations of AllCare’s Compliance, Community Engagement, Community Benefit, Equity, and Language Access programs to help ensure adherence to applicable rules, regulations, and state and federal contractual requirements.

2. Engages member representatives and local and state partners and stakeholders to support healthcare transformation and improve community health.

3. Supports project development and systems-change initiatives aligned with the Compliance Program, Community Health Improvement Plans, Health Equity Plan, State Health Improvement Plan, and strategic goals established by the Board of Governors.

4. Assists with the development of monitoring and reporting processes to support effective program operations and continuous improvement.

Job Duties

• Supports and contributes to AllCare’s mission, vision, and values.

• Supports communication and collaboration between AllCare leadership and departments, including Compliance, Integration, Equity, and Language Access.

• Builds relationships with members, community partners, and stakeholders throughout AllCare’s service area.

• Supports the Community Health Improvement Team, AllCare departments, and Community Advisory Councils in engaging community partners and stakeholders in Community Health Assessments, Community Health Improvement Plans, the Compliance Program, and Community Benefit programs.

• Travels throughout Jackson, Josephine, Curry, and Southern Douglas counties, with occasional travel to other areas of Oregon.

• Supports technical assistance and skill-building opportunities for AllCare employees and external partner organizations.

• Supports innovative systems-change initiatives designed to advance healthcare transformation and improve community health.

• Develops and maintains relationships with stakeholders representing marginalized and historically underserved populations.

• Attends community meetings and participates on applicable boards and councils.

• Identifies opportunities to develop and strengthen relationships with community partners and stakeholders.

• Supports program processes, budgets, reporting, and alignment with other AllCare projects and investments.

• Assists with reports and updates provided to the Oregon Health Authority, CCO Board, Quality Improvement Committee, and AllCare Health staff.

• Respectfully receives and follows direction from leadership.

• Completes all required training, including assigned Relias Learning Management System (LMS) training.

• Performs other duties as assigned.

On-Call Responsibilities

This position does not have on-call responsibilities.

Supervisory Responsibilities

This position does not have supervisory responsibilities.

Job Requirements

• May require the use of a personal vehicle for local travel, subject to mileage reimbursement.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, with or without reasonable accommodation. The requirements below are representative of the knowledge, skills, and abilities necessary for the position.

Bilingual candidates may be eligible for a pay differential.

Education & Experience

• Bachelor’s degree from a four-year college or university; or

• One to two years of related experience and/or training; or

• An equivalent combination of education and experience.

Certificates, Licenses and/or Registrations

• Healthcare compliance, fraud examination, auditing, or healthcare fraud investigation certification preferred, such as CFE, AHFI, CPCO, or CPMA.
• Valid Oregon driver’s license and proof of current vehicle insurance required.

Technical Skills

• Knowledge of or familiarity with the healthcare industry.

• Strong written communication, editing, and proofreading skills.

• Strong organizational and time-management skills.

• Proficiency with Microsoft Office applications, including Outlook, Word, PowerPoint, and Excel.

• Knowledge of HIPAA requirements and healthcare confidentiality standards.

• Knowledge of project management and/or change management principles.

• Ability to identify opportunities for process and program improvement.

• Ability to organize projects into measurable tasks and track progress through completion.

• Knowledge of research methodologies and/or data analysis.

• Ability to interpret data, identify trends, and use information to support problem-solving and decision-making.

• Ability to locate, evaluate, and synthesize information from multiple sources.

• Strong relationship-building and customer service skills.

• Ability to work effectively with community partners, stakeholders, and multidisciplinary teams.

• Awareness of how implicit bias, identity, power, and privilege can impact individuals, organizations, communities, and systems.

Interpersonal Skills

The successful candidate will be able to:

• Demonstrate accountability and build trust and confidence with others.

• Work independently and resolve routine conflicts or misunderstandings with minimal supervision.

• Work with initiative, energy, and effectiveness in a fast-paced environment.

• Communicate effectively and professionally with team members, community partners, stakeholders, and customers.

• Collaborate effectively within multidisciplinary and diverse teams.

• Prioritize and organize work across competing timelines and deadlines.

• Adapt to change, learn quickly, and work effectively with ambiguity.

• Use creativity, resourcefulness, and sound judgment to solve problems.

• Maintain professionalism and confidentiality.

• Work respectfully and effectively with individuals from diverse backgrounds and experiences.

• Provide respectful and inclusive service within a multicultural environment.

• Meet established timelines while maintaining a high level of quality.

• Consider multiple perspectives when addressing challenges or resolving differences.

• Make appropriate independent decisions within established policies and procedures.

• Take initiative and seek out information needed to understand AllCare’s environment and communities.

• Demonstrate cultural awareness and a willingness to examine and adapt behaviors as appropriate.

Language Skills

Ability to read, analyze, and interpret business and professional materials, technical procedures, and governmental regulations. Ability to prepare reports, business correspondence, and procedure documentation and effectively present information and respond to questions from leaders, partners, stakeholders, and the public.

Mathematical Skills

Ability to perform basic mathematical calculations using whole numbers, fractions, and decimals; calculate rates, ratios, and percentages; and interpret basic charts and graphs.

Computer Skills

This position requires proficiency with computer applications used for database management, spreadsheets, reporting, project management, word processing, presentations, email, and scheduling.

Reasoning Ability

Ability to solve practical problems, exercise sound judgment, and interpret written, oral, diagrammatic, or schedule-based instructions in situations where limited standardization may exist.

Physical Demands & Work Environment

The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this position, the employee is regularly required to sit, use their hands, and communicate verbally. The employee is occasionally required to stand, walk, and reach with their hands and arms. The noise level in the work environment is typically moderate.

The physical demands and work environment described above are representative of those encountered while performing the essential duties of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

• This position requires the employee to work onsite for all scheduled shifts.
• The employee must be able to travel locally, as needed.

Company Overview

AllCare Health is an Oregon Benefit Corporation and has maintained Certified B Corporation® status since 2017. We consider our impact on our community, society, and the environment as part of our business decisions.

AllCare Health headquarters are located in Grants Pass, Southern Oregon, along the Rogue River and surrounded by mountains, forests, small farms, and scenic outdoor recreation. The region offers access to rafting, fishing, hiking, biking, wineries, outdoor concerts, the Oregon Coast, redwood forests, and many other recreational and cultural opportunities.

Our Corporate Principles

Purpose | Working together with our communities to improve the health and well-being of everyone.

Values | Trust, Innovation, Relationships, and Voice.

Vision | Thriving, Inclusive, and Equitable communities.

Brand Promise | Changing Healthcare to Work for You.

AllCare Health is dedicated to building a diverse and authentic workplace centered on belonging and serving our growing community. If you are excited about this position but your experience does not align perfectly with every qualification listed, we encourage you to apply. You may be the right candidate for this role or another opportunity with AllCare Health.

If you need an accommodation, assistance with the application process, or this job announcement in an alternative format, please contact Human Resources at 541-471-4106.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disability status, genetic information, or any other status protected by applicable law.