The primary responsibility of the Compliance Consultant IV (CC IV) is to help manage, create and maintain relationships with the risk adjustment communities. The CC IV need to have a detailed understanding of the end to end processes of the encounter data development and submissions that is critical to risk adjustment. The position will require the ability to perform data analytics, causal factor analysis, design, develop and maintain dashboards for leadership reporting. In addition, the CC IV will be responsible for researching any new regulatory updates and/or changes and will communicate to the risk adjustment communities.
Researches, plans, implements, and monitors a broad portfolio of compliance systems and initiatives to enable organizational compliance with all applicable Federal, state, and local regulations/laws, as well as overseeing the protection of organizational assets. On an on-going basis, researches and interprets regulations and laws to establish compliance standards, and may develop and/or deliver training and communications/change management relative to new standards. Assesses organizational systems (both physical and process or data related) to determine gaps in compliance and determine opportunities for remediation. Advises the organization on all compliance matters. May investigate violations of compliance policy, laws, regulations, etc. or conduct on-going monitoring and reporting to ensure remediation. May be responsible for project management relative to new compliance initiatives, products, or annual processes.