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Report Specialist (Compliance), Hybrid

Company: MemorialCare Health System
Location: Fountain Valley
Posted on: November 25, 2022

Job Description:

The Reporting and Compliance Specialist collaborates in development and implementation of all aspects of UM/CM, including work plan activities, Health Plan reporting, internal and external audits. Includes working with internal staff to coordinate deliverables related to reporting and audits. Maintain and report status of deliverables to management team. Works with internal staff to obtain required reporting deliverables as requested by the external stakeholders, including but not limited to Health Plans, NCQA, CMS and other external agencies. Represents department and acts as a liaison between medical management and IT department related to problem resolution updates, changes and system enhancements.


* A minimum of 2-5 year experience in Managed Care

* Strong interpersonal communication, customer service, time management, analytics and organizational skills required

* Advanced computer proficiency in Microsoft Office: Outlook, Word, Excel and Power Point

* Knowledgeable with NCQA, CMS and DMHC auditing requirements.

* Experience in EPIC Reporting and Health Plan reporting for NCQA, CMS and DMHC

* Knowledgeable of medical terminology

Keywords: MemorialCare Health System, Fountain Valley , Report Specialist (Compliance), Hybrid, Other , Fountain Valley, California

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