Compliance & Quality Assurance Analyst

Compliance And Quality Assurance Analyst (Journey Level)

The Department of Health & Social Services is recruiting for a Compliance and Quality Assurance Analyst (Journey level) to support the goals of the department and objectives of an effective compliance and quality assurance program, including the promotion of positive and ethical principles and conduct. Under supervision, this position will review, monitor and evaluate areas of risk within the Health & Social Services Department, with a goal of regulatory compliance and continuous quality improvement. This position will research laws and regulations, evaluate program activities, participate in root-cause analysis, problem resolution and other corrective action and recommend policy and program changes. This position will be responsible for enforcement of Federal/State privacy regulations and investigate privacy breaches and security incidents.

Core competencies include:

• Exhibits professional acumen and effectiveness
• Develops and promotes productive relationships and rapport with key stakeholders
• Demonstrates Emotional Intelligence (EI)
• Proficient in interpreting local, state, and federal compliance and privacy laws and regulations as well as hands-on implementation and experience with statutory, regulatory, and contractual requirement
• Excellent oral and written communication skills
• Experienced in performing complex compliance investigations and developing investigative reports.
• Excellent critical thinking skills and organizational awareness
• Competent and skilled to perform compliance work with minimum guidance.
• Experienced in performing risk assessments and development and implementation of compliance workplans.

Must have a good understanding of federal and state laws and regulations applicable to the conduct of compliance and quality assurance reviews such as:

• Health Insurance Portability and Accountability Act (HIPAA)
• Health Information Technology for Economic and Clinical Health Act (HITECH)
• Public Health activities
• Federal and state privacy laws as applicable to health and social services programs
• CMS Medicare and Medi-Cal Conditions of Participation
• Federally Qualified Health Centers (FQHC)
• 21st Century Cures Act
• 42 CFR Part 2
• Behavioral Health programs

Position requirements include:

• Education: Bachelor's degree or higher from an accredited college or university with a major in Accounting, Business Administration, Finance, Health Administration, Public Administration, Social Work, or a closely related field.
• Experience: Two years of full-time paid experience in a public or non-profit social services or public health agency performing work in one or more of the following areas: regulatory compliance, quality assurance, legal analysis, health law and/or administration, health or social services information management, and/or regulatory investigations of health care.

Licensing, certification and registration requirements include:

• Applicants are required to possess a valid California Driver's License, Class C.
• Employees are required to obtain a Healthcare Compliance Certificate from the Health Care Compliance Certification Board within one year of appointment.
• Possession of one of the following valid licenses issued by the State of California may be considered during the rating and/or selection process: Physician; Licensed Psychologist; Licensed Clinical Social Worker; Licensed Marriage, Family and Child Counselor; or Registered Nurse.