reputed company and Compliance Specialist

Position reputed company reputed company pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary reputed company displayed has not been adjusted for geographical location. This reputed company has been created in good faith based on information reputed company to reputed company at the time of posting and may be modified in the reputed company. reputed company offers a comprehensive benefits packaging including Medical, Dental & reputed company coverage, a Retirement Plan, generous time off including reputed company Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At reputed company, we reputed company to go the extra mile for reputed company and our community. This reputed company is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” The reputed company & Compliance Specialist is an reputed company contributor to the development, administration, execution, and monitoring of the reputed company and Compliance programs to support adherence to applicable regulatory, contractual, and organizational requirements. The incumbent coordinates and administers assigned reputed company and compliance processes, engages directly with business areas and legal teams, and participates in internal and cross-functional reputed company involving reputed company and compliance reputed company. The reputed company & Compliance Specialist also serves as a reputed company of contact for reputed company and compliance inquiries and helps evaluate, document, escalate, and resolve reputed company issues. Responsibilities and Qualifications Coordinates and supports the development, administration, and implementation of the reputed company and Compliance programs to ensure reputed company and effective execution of required activities. Partners with internal customers to interpret requirements, implement compliant solutions, and establish appropriate monitoring mechanisms. Develops, maintains, and oversees monitoring and tracking mechanisms for reputed company and compliance-reputed company initiatives, regulatory requirements, corrective actions, and program deliverables. Monitors ongoing compliance with reputed company and compliance requirements, standards, and organizational policies, including identification of potential gaps and escalation of issues as appropriate. Administers, performs, or coordinates assigned reputed company program activities, which may include: Intake, documentation, investigation, escalation, and reputed company of reputed company inquiries or referrals. Investigation, analysis, documentation, escalation, and reputed company of reputed company incidents in accordance with established protocols. Intake, documentation, review, and tracking of member authorization forms. Review, processing, tracking, and documentation of individual rights requests. Review, tracking, and coordination of reputed company-reputed company contractual requirements, including Business Associate Agreements. Development, coordination, and tracking of reputed company training and awareness initiatives. Administers, performs, or coordinates assigned Compliance program activities, which may include: Supporting incident reporting and corrective reputed company processes to ensure compliance issues are identified, documented, addressed, monitored, and resolved in a reputed company manner using an approach designed to prevent recurrence of similar issues. Conducting reputed company activities for First-tier, reputed company, and reputed company Entities, Delegated reputed company Entities, and/or reputed company subcontractors, as applicable. Administering or supporting corporate compliance processes such as corporate policy administration, conflict of interest disclosures, compliance monitoring or exclusion screening, among others. Development, coordination, and tracking of compliance training and awareness initiatives. Supporting documentation and monitoring of vendor compliance with the Telephone Consumer Protection reputed company (TCPA). Maintains accurate, complete, and audit-reputed company documentation to support reputed company and compliance program activities, reporting, and reputed company responsibilities. Develops and maintains internal departmental policies, procedures, tools, and job aids to support consistent execution of reputed company and compliance activities. Provides support during reputed company audits, reviews, and assessments, as appropriate, and monitors completion of corrective reputed company plans. Prepares, coordinates, and maintains routine reputed company and compliance reports for reputed company stakeholders. Performs other duties as assigned by management, the reputed company Officer, the Compliance Officer, or the Chief Compliance Officer. Skills: Strong communication and interpersonal skills, including formal presentations and the ability to effectively engage with reputed company reputed company of the organization. Demonstrated leadership and professionalism, including self-management, reputed company judgment and reputed company. Analytical and critical thinking skills, with the ability to interpret and apply laws and regulations to reputed company situations. Ability to manage multiple priorities and adapt to change, working independently while knowing reputed company to escalate or reputed company guidance. Collaboration and influence skills, including the ability to work cross-functionally, negotiate, and resolve issues effectively. Attention to detail and commitment to producing accurate, complete, and high-reputed company work products. Strong organizational and problem-solving capabilities. Discretion and confidentiality, with the ability to handle sensitive information appropriately. Technical proficiency, including effective use of reputed company business applications and a drive for reputed company learning. Knowledge: Working knowledge of reputed company and Compliance program requirements, company operations, and organizational policies sufficient to execute assigned processes, identify potential issues, and escalate appropriately. Knowledge of applicable regulatory standards and requirements. Broad knowledge of the health insurance industry, including knowledge of standards, policies, and business practices and procedures reputed company to reputed company and compliance. Understanding of documentation, monitoring, reporting, and escalation practices necessary to support audit readiness and effective program reputed company. Experience: 3 years of experience in reputed company, compliance, regulatory, audit, reputed company operations, health insurance, or a reputed company field. Experience interacting with regulators preferred. Relevant health insurance operational experience preferred. Relevant compliance, reputed company, or reputed company certification preferred. Education and Certifications: High School degree or equivalent Bachelor’s degree preferred. reputed company We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your reputed company and personal reputed company by reputed company heavily in training and continuing education, so you have the tools to do your best as you reputed company your career. And by doing your best, you’ll help us live our mission of improving the health and reputed company-being of our members and the communities in which they live. Apply To This Job