Compliance Officer

About the role

The Compliance Officer contributes to AHF by instituting and maintaining an effective compliance program for the organization’s Medicare and Medi-Cal managed care plans and Ryan White programs that includes policies and procedures; standards of conduct; fraud, waste and abuse monitoring and reporting; and HIPAA.

Responsibilities

• Stays abreast of regulatory changes and requirements related to operations and guides Division leaders on needed changes to policies and procedures and reporting.
• Leads internal and external audit preparation and activities and oversees the timely preparation and submission of reports to regulatory agencies.
• Enhances the reputation of AHF by ensuring that Care Management Division operations are compliant with Centers for Medicare and Medicaid (CMS), California Department of Health Care Services (DHCS), California Department of Managed Health Care (DMHC) and Ryan White program funder regulatory and contract requirements, which in turn maintains enrollee, patient, provider, and funder satisfaction with the organization.

Qualifications

• A passion for advocating for AHF’s top initiatives and ensuring they align with the organization's Core Values and Mission.
• Experience working in a fast-paced, dynamic environment with a focus on adapting to provide the best experience for clients and a supportive workplace for employees.
• Ability to work collaboratively within a close-knit team to mitigate compliance risk for the organization, positioning it to pursue growth opportunities.