Job Details

The compliance analyst for the Grievance & Appeals (G&A) department plays a key support rolein ensuring the department maintains compliance with regulatory, accreditation, and internalstandards. Under the direction of the G&A Compliance Manager, this role is responsible forassisting with policy and the procedure maintenance, audit preparation and support, andoversight of delegated entities. The compliance analyst also plays a critical role in identifyingprocess and quality improvement opportunities through data analysis and trending of grievanceand appeal cases. This is a dynamic and multifaceted position that supports various complianceactivities to maintain organizational readiness for internal audits, external reviews - such as. Centers for Medicare & Medicaid Services (CMS), California Department of Health CareServices (DHCS), and National Committee for Quality Assurance (NCQA), and delegateoversight. Responsibilities ? Analyzes G&A data to identify trends, root causes, and opportu...Compliance Analyst, Compliance Manager, Compliance, Reporting Analyst, Healthcare, Analyst, Technology