Job description

Hybrid - Work from home opportunity but must be local enough to Spring Hill, FL to come into office once per week.

Ultimate Health Plans, Inc. (“UHP”) is a fast growing Medicare Advantage health plan with its headquarters located in Spring Hill, Florida. UHP plans provide all the benefits of Original Medicare Parts A and B, plus additional benefits not available with Original Medicare.

The Compliance Coordinator supports the Compliance Department’s Compliance Program and Fraud, Waste and Abuse Program by partnering with operational business units to ensure compliance with Federal and State rules and regulations of governmental and contractual entities. The Compliance Coordinator will provide analytical support to the Compliance department.

Essential Duties and Responsibilities may include, but are limited to the following:

• Assist in the implementation of the compliance work plan and the execution of the Compliance Workplan activities.
• Assist with Internal Auditing and Monitoring activities
• Partners with business areas to identify potential areas of compliance vulnerability and risk and develops corrective action plans for resolution of problematic areas.
• Provides updates on a regular basis to the Compliance Officer and Compliance Manager and other leadership.
• Coordinates, interacts and assists with responses to CMS or other regulatory/accreditation site visits, audits, surveys, etc.
• To perform the job successfully, an individual should demonstrate the following competencies:
• Strong written and communication skills
• Excellent interpersonal skills, including interview techniques for investigations and discretion in confidential or sensitive matters
• Strong analytical and critical thinking ability
• Knowledge of HPMS and Acumen
• Proficiency in Microsoft Office programs and database query tools specifically excel.
• Knowledge of HIPAA, False Claims Act and CMS Managed Care Manuals.
• Initiate and follow through on compliance audits and projects with little supervision or guidance

Must possess excellent organizational skills with demonstrable ability to clearly and concisely analyze facts within the context of the regulatory environment

Assist in formulation of policies and procedures, ability to understand and interpret policies and procedures and coordinate editing and review of policies and procedures

Must be able to work independently in high pressure environment

Must be able to meet regulatory deadlines

Education and/or Experience

Bachelor's degree (B. A.) from four-year college or university preferred; 3 plus years related experience and/or training; or equivalent combination of education and experience.

Project management skills are strongly desired.

Experience supporting Medicare Advantage products and HPMS is required.

Job Type: Full-time

Pay: $35,000.00 - $45,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Spring Hill, FL 34609: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• Medicare Advantage and NCQA: 1 year (Preferred)
• HIPPA and False Claims Act: 1 year (Preferred)
• Knowledge of HPMS and Acumen: 1 year (Preferred)
• * Internal Compliance Audits: 1 year (Required)
• Healthcare Compliance: 1 year (Required)
• CMS Managed Care Manuals: 1 year (Required)

Work Location: Hybrid remote in Spring Hill, FL 34609

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