VENDOR COMPLIANCE SPECIALIST

JOB PURPOSE:

The Vendor Compliance Specialist working with CenterLight's Business Owners will assist the department in providing oversight of the First Tier, Downstream and Related Entities (FDRs), and other vendors that perform administrative and health care services functions on behalf of CLHC to ensure compliance with all contractual and regulatory obligations. The Vendor Compliance Specialist is also responsible for identifying and tracking potential operational risks posed by a vendor's activity.

JOB RESPONSIBILITIES:

• Assists in performance of risk assessments for each delegated entity, and ensures reporting, monitoring, and audits capture the review of the risks identified.
• Work with Regulatory Compliance to ensure any implementations impacting our vendors are appropriately completed. This includes disseminating guidance and gathering the necessary documentation.
• Manage ongoing monitoring activities and execute audits as defined in the annual compliance work plan.
• Respond to questions and concerns relating to vendor compliance requirements with Business Owners.
• Develop, issue, and monitor corrective action plans as issues arise from ongoing monitoring and auditing activities. Must be able to track, trend, and escalate matters as needed.
• Ensure Business Owners are kept abreast of compliance-related issues. Work with Business Owners on an ongoing basis.
• Create, review and submit internal and external reports as required. Will need to engage with leadership from various departments and vendors to compile information needed for responses. Includes data submitted for the Delegated Vendor Oversight subcommittee (DVOC), Compliance Committee, and the Board of Directors. For the DVOC, the Vendor Compliance Specialist is responsible for obtaining and reviewing vendor reports and identifying issues.
• Ensure business areas are conducting ongoing monitoring of delegated functions by reviewing monthly reports sent to business areas for compliance risks. Business areas should be submitting a monthly assessment of the vendor's performance. Any compliance issues must be investigated and escalated where necessary.
• Conduct an annual assessment of the delegated oversight program.
• Responsible for ensuring P&P's related to vendor compliance are reviewed and updated annually and as regulatory changes occur.
• Participates in strategic planning of delegation activities, as well as initiatives to improve quality and service provided by vendors. May lead work teams, workgroups, and committee discussions to address specific delegation standards requiring focused attention.
• Participates in annual and ongoing audits of delegated entities. Audits include a review of related policies and procedures, review of downstream oversight, and compliance with regulatory and plan requirements. Responsible for the issuance of the final audit report and any corrective action plans needed.
• Perform other duties as required, consistent with the goals, objectives and responsibilities of the Compliance department.

Section 3 - Corporate Standards

Performance Standards

• Performs consistently with the organization's mission and philosophy.
• Performs job responsibilities according to the organization's policies. Seeks clarification when needed.
• Assumes responsibility for assignments given, seeks supervision appropriately, and is accountable for work performance. Meets productivity guidelines.
• Maintains HIPAA standards and confidentiality of PHI.
• Supports staff, interns, apprentices, volunteer orientation, and ongoing in-service education as requested.
• Supports organizational activities by participating in quality improvement activities, special projects, internal and external committees, community activities, and other duties as assigned.
• Serves as a role model for peers and colleagues.
• Assumes responsibility for professional growth and development; maintains and upgrades professional knowledge and practice skills.
• Treats other CenterLight employees respectfully and facilitates an environment of teamwork.
• Initiates, if appropriate, the incident reporting process and participates in incident investigation and reporting as applicable.
• Performs general office duties in connection with job responsibilities, including but not limited to photocopies, faxing, typing, filing, and phone calls.

Service Standards

• Makes the needs of the Compliance Department their central focus and finds innovative ways to provide an exceptional experience.
• Develops and maintains positive "customer" relationships ("customer" is defined as co-workers, staff, interns, supervisors).
• Communicate with customers in a caring, helpful, considerate, and culturally sensitive manner.
• Demonstrates a thorough understanding of customer needs and wants and attempts to anticipate and meet customer needs.
• Suggests and implements customer-centered service improvements.
• Encourages customers to engage with CenterLight employees and CenterLight activities.

Schedule: 8:30AM - 5:30PM

Weekly Hours: 40

QUALIFICATIONS:

EXPERIENCE:

• Bachelor's Degree required,
• Prior successful experience working with regulators on compliance audits, reporting, and other matters.
• Knowledge of PACE regulations, especially in relation to vendor oversight.
• Experience organizing, coordinating, and participating in FDR monitoring and auditing.
• Experience with developing reporting and metrics
• Three (3) or more years of professional experience in vendor relations preferred.
• Microsoft Excel skills and strong proficiency using MS Word, PowerPoint, and SharePoint
• Experience leading interdepartmental and cross-functional projects; experience working with professional
• Excellent oral, written, and presentation skills.
• The ability to comprehend and interpret regulatory, legislative, and contractual mandates.

Physical Requirements

Individuals must be able to sustain specific physical requirements essential to the job. This includes, but is not limited to:

• Standing - duration of up to 6 hours a day
• Sitting/Stationary positions - sedentary position for a duration of up to 6-8 hours a day for consecutive hours/periods.
• Lifting/Push/Pull - up to 50 pounds of equipment, baggage, supplies, and other items used in the job scope using OSHA guidelines, etc.
• Bending/Squatting - have to be able to safely bend or squat to perform the essential functions under the scope of the job.
• Stairs/Steps/Walking/Climbing - must be able to maneuver stairs safely, climb up/down and walk to access work areas.
• Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools to complete essential job functions (i.e., typing, use of supplies, equipment, etc.)
• Sight/Visual Requirements - must be able to read documentation, papers, orders, signs, etc., and accurately type/write documentation, etc.
• Audio Hearing and Motor Skills (language) Requirements - must be able to listen attentively and document information from patients, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy. In addition, one must be able to speak comfortably and clearly with language and motor skills for customers to understand an individual.
• Cognitive Ability - Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.

Disclaimer: Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.

We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

Salary Range (Min-Max):
$90,000.00 - $100,000.00