Are you a detail-oriented professional with an interest in compliance and policy? UPMC Health Plan is looking for a Lead Coordinator, Compliance to join our team. This is a full time position working Monday through Friday daylight hours and will be a hybrid shift working 3 days in the office and 2 days from home.
The Compliance Coordinator, Lead shall be primarily responsible for administering the UPMC Insurance Services Division Policy and Procedure review process, and facilitating the ISD Board Documentation collection along with other departmental projects as assigned by the Compliance Program Operations Office leadership team.
Directly responsible for administering Insurance Services Division policy and procedure processes, and overall policy communication to the Compliance Program Operations Leadership team. Work with all departmental liaisons to the Compliance Program Operations Office to assist in enforcing all deadlines and other requirements relative to the submission, review, access, and maintenance of policies and procedures. Maintain all policies and procedures in an organized and thoughtful manner including the preservation of former versions of Insurance Services Division policies and procedures.
Establish a thorough working knowledge of the policies and procedures and assist in developing and modifying all stakeholders. Oversee the internal quality verifications to ensure compliance with the established corporate Policy and Procedure on policy management. Facilitate all meetings of the Policy and Procedure Committee.
Develop training programs and/or improvement initiatives for Policies and Procedures, to include group and individual trainings. Provide assistance to the Compliance Program Operations Leadership team with the training, orientation, and ongoing guidance of relative Compliance materials. Oversee the quality review of departmental Sites for accuracy and validity of Compliance related information and permissions.
Facilitate the collection of Insurance Services Division Board Member document collection (Conflict of Interest and Biographical Affidavits), preservation, tracking and overall coordination and partnership with key stakeholders, internal and external. Assist with accurate and timely reporting of Compliance Program Operations topics (Policies and procedures, and Board documentation) when related to audit requests and licensing needs.
Respond timely to regulatory and audit policy and procedure requests. Work on other compliance related projects as required by the Compliance Program Operations Leadership team. Bachelor's degree or equivalent combination of education and/or relevant experience required. 3-5 years of experience in the insurance industry and/or managed care programs is required.
Previous supervisory experience is strongly preferred. Excellent written and oral communication skills and ability to critically review government regulations and policies and procedures. This position requires a high degree of organizational skills.
Proficiency in Microsoft Word and ability to learn new software as needed. Must be self-motivated and capable of meeting deadlines. Licensure, Certifications, and Clearances: Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran