Description

American Specialty Health Incorporated is seeking a Compliance Training & Research Specialist to join our Regulatory & Program Compliance department. This position will ensure the organization complies with regulations or laws that apply to our business. Compliance is critical in regulated industries such as health care and a lack of training and understanding of product operations puts a company at risk of noncompliance and subsequent fines or legal action. Under general supervision, the Compliance Training & Research Specialist is responsible for research, and providing, coordinating, documenting, maintaining, and scheduling regulatory training activities. This position is also responsible for developing, revising, and implementing the use of training documents including SOPs and processes to support the overall compliance program.

Responsibilities

• Plan and create programs that will develop awareness and understanding of compliance issues.
• Assess and decide whether to train individuals through ASH University, on a one-on-one basis, or conduct group sessions using their own presentations or materials.
• Stay current and aware of upcoming changes in legislation so that they can plan programs to update staff on the latest requirements.
• Explain regulations and compliance polices to staff as needed. Communicate the risks and consequences of noncompliance.
• Develop feedback mechanisms to ensure that employees understand the training content and can put the instruction into practice.
• Develop training aids to give to employees to reinforce the messages from the training courses.
• Maintain comprehensive records of training for individuals or departments and regularly provide reports to the Associate Vice President, Regulatory & Program Compliance and other internal stakeholders.
• Submit training records to regulators as part of an audit to demonstrate compliance.
• Utilize training records for planning future programs to cover changes in legislation or compliance problems.
• Maintain and understand general compliance requirements at ASH and stay aware of the specific responsibilities of individual employees or departments.
• Support non-compliance training programs by providing coordination assistance as requested or needed.
• Collaborate with internal business owners, research, and confirm that operational action items have been effectively closed out.
• Collaborate with internal business owners to establish operational changes that meet new or updated compliance requirements, and train employees on those changes.
• Perform other duties and projects as needed or assigned by the Associate Vice President, Regulatory Compliance, Vice President of Regulatory Strategies, or Chief Legal Officer.

Qualifications

• Bachelor’s degree in Law, Health Care Administration, Health Policy & Management, English or business-related field required. Master’s degree in Health Care Administration, Legal degree, or equivalent preferred. 
• Minimum 2 - 3 years’ compliance training experience or regulatory compliance experience, preferably in a health insurance and managed care environment.
• Experience must include development of training materials for compliance programs, presenting effective trainings, and record keeping of completed trainings.
• Experience researching managed care and insurance law and/or provider group compliance.
• Preferred experience includes research across multiple jurisdictions and markets. Experience with measurement of compliance program effectiveness.
• Excellent understanding of managed care, health insurance, Medicare Advantage and Medicaid laws and regulations.
• Understanding of Provider Group compliance requirements.
• Ability to research, track and report on legislative, regulatory, and sub-regulatory guidance to assist with product compliance, product development and to plan training programs to update employees on the latest requirements.
• Ability to clearly explain legislation, regulations and company compliance polices.
• Good presentation and people skills, including the ability to differentiate between audiences and provide the appropriate level of compliance trainings to a diverse cross-section of employees.
• Ability to develop feedback mechanisms to ensure that employees understand trainings and can put the instruction into practice.
• Ability to maintain comprehensive records of training for individuals or departments and provide reports to compliance managers and business owners.
• Effectively close out action items and collaborate with internal business owners to establish operational changes that meet new or updated compliance requirements.
• Ability to recognize consequences of noncompliance and the ability to explain noncompliance risks to employees effectively.
• Superb planning skills to create programs that will develop awareness and understanding of compliance issues.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. Able to stand or sit and talk for the duration

of a training presentation.

Physical Requirements

Ability to speak clearly, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to work from home.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

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