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Legal Compliance Specialist, Camarillo, CA


Organization: Gold Coast Health Plan
Category: Professional
Location: Camarillo, CA
Date Job Posted: August 29, 2022
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Legal Compliance Specialist

Full Time Regular
Camarillo, CA, US

Requisition ID: 1312

POSITION SUMMARY

Under general supervision of the Chief Compliance Officer, the Compliance & Legal Specialist performs a variety of duties including coordination of legal inquiries, fraud waste and abuse investigations, privacy breach incidents and assisting as an internal auditor. The Compliance & Legal Specialist is responsible for intake, initial review and coordination of tasks and deliverables in response to Plan legal inquiries, and is accountable for timely, accurate and complete responses, within required deadlines. The role requires a thorough knowledge of the Plan’s business, organizational procedures, and key internal and external contacts as well as the Public Records Act and the Plan’s records retention policies. The Compliance & Legal Specialist must be professional, well organized, and maintain a high level of confidentiality, while frequently working under short deadlines. The ideal candidate for this position should be one who is flexible with work assignments and thrives in a fast-paced environment. This position requires expert level written and verbal communication skills, strong decision-making ability, time management skills, computer skills, and attention to detail.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s)

  • Respond to and coordinate acknowledgement of legal inquiries and requests to applicable parties and stakeholders.
  • Liaison between legal entities, including General Counsel, and Plan staff for all legal related inquiries and requests.
  • Organize inquiries and requests by establishing an intake and tracking system to ensure timely response, within required deadlines.
  • Coordinate resources, manage tasks/deliverables for all legal related inquires, and requests.
  • Coordinate communication with Genera; Counsel on matters related to legal inquiries and requests.
  • Produce information by transcribing, formatting, inputting, editing, copying, and transmitting, text, data, and graphics.
  • Research, compile and analyze responses for legal inquiries and requests.
  • Draft responses to letters and general correspondence of a legal nature for Plan's General Counsel to review and approve.
  • Prepare reports, correspondence, memos, minutes, and other written materials.
  • Coordinate Plan responses to Public Records Requests and subpoenas.
  • Copy, fax, and distribute documents through mail or in person.
  • Inform Chief Compliance Officer and staff (as applicable) on status of all legal related matters by providing regular updates - both written and oral.
  • Draft and deliver status reports to Chief Compliance Officer for legal inquiries at summary and detail level review.
  • Prioritize and manage Compliance projects simultaneously while following through on issues in a timely manner.
  • Investigate Fraud, Waste and Abuse cases and complete timely reporting to DHCS within regulatory timeframes.
  • Assist GCHP Privacy Officer on privacy incidents including conducting workstation audits.
  • Compile reports on privacy incidents and report to regulatory agency within required timeframes.
  • Assist and support Compliance Specialist activities.
  • Maintain a high level of confidentiality, ethics, and professionalism.
  • Perform other duties, as assigned.

POSITION QUALIFICATIONS

Competency Statement(s)

  • Accuracy - Ability to perform work accurately and thoroughly.
  • Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
  • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.
  • Business Acumen - Ability to grasp and understand business concepts and issues.
  • Communication, Oral - Ability to communicate effectively with others using the spoken word.
  • Communication, Written - Ability to communicate in writing clearly and concisely.
  • Time Management - Ability to utilize the available time to organize and complete work within given deadlines.

SKILLS & ABILITIES

Education: High School Graduate or General Education Degree (GED): Required

Certificate of completion from a legal administrative assistant program and/or two years' legal administrative assistant experience.

Paralegal certificate/degree or other appropriately related experience preferred.

Knowledge of legal and medical terminology: Required

Experience: 2 plus years of experience in capacity of legal assistant. Experience in managed health care, specifically in Medi-Cal programs, preferred.

Experience in public or government agencies, preferred.

Computer Skills: Advanced skills in operating Microsoft Office Suite particularly MS Word, Excel, Access and PowerPoint. Solid data-entry skills with high degree of accuracy.

Certifications & Licenses: Paralegal certificate/degree or other appropriately related experience preferred. Valid California Driver's License and insurance.

Other Requirements:

Knowledge of proper handling of highly sensitive and confidential information. Superior work ethic and accountability.

Ability and initiative to meet deadlines in a busy environment with frequent interruptions. Ability to understand and carry out a variety of instructions.

Skill to compose correspondence and other documents following a template or established format.

Demonstrated competent level of organizational skills. Excellent oral communication skills.

Solid interpersonal skills and the ability to be a team player who can easily establish and build relationships and communicate clearly at all levels within the business.

WORK ENVIRONMENT

Office work environment.

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