LogistiCare Solutions, LLC
The Compliance Specialist Lead ensures contract fulfillment of insurance requirements and credentialing of sub-contractor vehicles and drivers. He/she provides leadership support on the development, implementation and execution of all LogistiCare compliance program efforts that establish a culture within LogistiCare promoting adherence to relevant federal and state laws, contract standards, and LogistiCare's ethical standards. He/she will facilitate communication to manage these expectations in a timely manner.
* Facilitates the training of Compliance QA Specialists
* Ensures compliance with applicable federal and/or state laws, regulations, and/or agency rules, contract standards and guidelines etc.,
* Verifies provider documents and ensures that they meet contract requirements.
* Provides quality reporting feedback to assist in creation of performance improvement goals and the development of training programs.
* Identifies common errors or weaknesses in Compliance QA Specialist or work flows
* Ensures accurate and timely data review and reporting.
* Proactively partners across all departments to manage the timely satisfaction of LogistiCare's obligations under all contract agreements.
* Make observations and recommendations for improvement to the Field Services Management team.
* Maintain strong working knowledge of LogistiCare operations and procedures.
* Ensure work delivered is processed accurately
* Prepare and organize provider files for audits
* Create, analyze and provide reports to both internal and external customers
* Assist with the reviewing of all contracts for completeness before forwarding to the corporate office for execution
* Help develop and create departmental training manual and document processes
* Meets all departmental deadlines
* Adheres to company policies and procedures
* Performs other duties as assigned
* Analytical Skills - Ability to use thinking and reasoning to solve a problem
* Communication, Oral - Ability to communicate effectively with others using the spoken word. Must be a good listener
* Communication, Written - Ability to communicate in writing clearly and concisely
* Customer Oriented - Ability to take care of the customers' needs while following company procedures.
* Decision Making - Ability to make critical decisions while following company procedures.
* Interpersonal - Ability to get along well with a variety of personalities and individuals.
* Management Skills - Ability to organize and direct oneself and effectively supervise others.
* Problem Solving - Ability to find a solution for or to deal proactively with work-related problems
* Relationship Building - Ability to effectively build relationships with customers and co-workers
* Working Under Pressure - Ability to complete assigned tasks under stressful situationsEducation
* High School Graduate or General Education Degree (GED)
* AA degree is preferredExperience
* 5 years of customer service and credentialing
* More than 5 years quality review/audit experienceSKILLS & ABILITIES
* Proficient in Microsoft Office (Excel, Word, etc) intermediate and/or above
* 35 WPM
* Must possess excellent written and verbal communication skills to facilitate effective communications and correspondence with internal and external management and clients ability to train and teach others
* Must be able to create, analyze and interpret data and reports
* Must be proficient in their presentation skills
* Ability to handle sensitive situations with tact and diplomacy
* Ability to take initiative and think outside of the box in determining corrective actions for departmental/operational audits
* Ability to read, interpret and apply laws, rules, regulations, policies and/or procedures
* Strong project management, time management and organizational skills
* Ability to problem solve and think through situations and determine a solution
* Excellent Customer Service skills
* Strong Attention to Detail
* Self-Awareness and understanding of Quality in work presentation
* Ability to multi-task and work under pressure
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
LogistiCare Solutions, LLC
Website : http://www.logisticare.com
We are LogistiCare, and we make sure our clients' customers get where they need to go. Our clients range from state government agencies, managed care organizations and hospitals to transit authorities and school boards. Their customers include Medicaid and Medicare populations, commercial and senior members, special-needs students and ADA paratransit riders. We are not a transportation company. We do not operate vehicles, drive buses or fly planes. We assemble and manage comprehensive transportation networks for our clients, usually under full-risk capitated financial arrangements.