Senior Compliance Specialist

Senior Compliance Specialist

We are looking for a Senior Compliance Specialist, someone who's ready to grow with our company. In this position, you will independently and cooperatively plan and manage audits, reviews, investigations and projects to ensure compliance with Texas Children's policies/procedures and state and federal rules, regulations and statutes. To identify risks by conducting ongoing risk assessments for Texas Children's and document and report the risk(s) to Senior Management. Think you've got what it takes?

Job Duties & Responsibilities

• Conducts and manages compliance audits, reviews, projects or investigations
• Ensures that written reports and correspondence are organized, accurate and appropriate in content and convey reported issue(s)
• Assists operational area with implementing recommended changes to enhance operations or mitigate risk
• Conducts compliance training and assists in the on-going development/maintenance of the organization's compliance program
• Monitors regulatory environment; evaluates statutes, regulations, laws to determine applicability to Texas Children's and communicates information to TCHP personnel
• Leads the work of Compliance Specialists, Compliance Assistants and others

Skills & Requirements

• Required High School Diploma or GED - preferred Bachelor's Degree
• Preferred Licenses/Certifications: CPC - Cert-Cert Professional Coder, CCS-P - Cert-CCS-P Physician Based, RHIA - Cert-Reg Health Inform. Admins, CCS - Cert-Cert Coding Specialist, CHC - Certified in Healthcare Compliance
• Required 9 years in a healthcare regulatory environment including specific experience in project management and audit type work such as planning, supervising, executing, and reviewing audits, reviews, or investigations.

Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.