Providence Health & Services Compliance Medicaid 1 Specialist in Beaverton, Oregon
Providence St. Joseph Health is calling a Compliance Medicaid I Specialist to our location in Beaverton, OR.
We are seeking a Compliance Medicaid I Specialist who will be responsible for assisting the Medicaid Compliance Program Manager with high level duties related to the effective implementation, monitoring and continuous improvement of the seven elements of the Health Plan's Medicaid Compliance Program. This position coordinates the fulfillment of several compliance requirements, as specified below.
· Compilation and submission of OHA, CMS, Health Share of Oregon and MSO client reports and audits.
· Independently handles regulatory compliance duties as delegated by the Medicaid Compliance Program Manager.
· Professionally represents Providence Health Plans to a variety of external stakeholders.
Coordinating emerging priorities and multiple assignments with tight deadlines.
Maintaining up-to-date knowledge of the Medicaid environment and how it relates to compliance requirements and key operational systems at PHP.
Establishing positive and effective relationships with various internal and external stakeholders.
Managing a multitude of activities and relationships in a highly matrixed organization.
Patient Population Served: Not Applicable
In this position you will have the following responsibilities:
Assists the Medicaid Compliance Program Manager in developing, implementing, and executing PHP's Medicaid Compliance Program.
Tracks due dates and coordinates the submission and confirmation of approval of Medicaid contract requirements, called Exhibits.
Tracks due dates, progress of completion and coordinates the submission and confirmation of Health Share of Oregon and MSO client audits.
Assists and participates in Compliance Program initiatives.
Reviews changes to Operations documentation and reviews policies and procedures with minimal consultation from the Medicaid Compliance Program Manager.
Required qualifications for this position include:
2 years relevant health plan, compliance and / or legal experience or experience in another regulated industry. Specific experience in Medicaid compliance preferred.
Process improvement, policy and procedure development, legal or technical writing, written customer communications.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities. The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple, "Providence will provide the best care and service to every person, every time." Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Compliance
Req ID: 312051