Associate, Compliance

About the Role

The Compliance Associate will join a team whose mission is to identify, analyze and mitigate internal and external risks, by creating and delivering a comprehensive regulatory program for the management of data and controls to protect the company from regulatory risk, driving management action towards addressing those risks.

The candidate will need to possess the ability to read and interpret regulatory requirements, demonstrate stakeholder engagement and advocacy skills, as well as the ability to engage with a wide network of people across the company to ensure we are mitigating risk and working towards overall compliance.

Responsibilities

• Support compliance with regulatory requirements for the member spend process through the review and adjudication of all submitted requests, including:
• Classification of request
• Ensuring complete documentation
• Track transactions by member and exception/safe harbor to ensure compliance with payment limits.
• Collaborate with internal care teams and stakeholders where necessary to fully understand the request and obtain needed documentation to enable members to compliantly receive the full benefits of the program
• Identify and address instances of non-compliance.
• Provide process/policy training to educate care teams about the program and targeted training to address non-compliance.
• Perform trend analysis of approved and denied transactions by market and in total
• Identify and support the implementation of process improvements
• Provide reports to markets and leadership on trends and compliance rates
• Support the regulatory compliance, corporate compliance and internal audit functions

Requirements for the Role

• Bachelor’s degree degree in Healthcare Administration, Risk Management, Nursing, Paralegal or Law, or a related field. CHC preferred
• 2+ years of experience with a highly regulated industry, which includes reading, interpreting, and operationalizing legislation and regulations.
• Strong analytical and problem-solving skills, an intellectual curiosity to understand true underlying trends, seeing around corners, and the driving towards continuous process improvement and problem-solving at scale
• Strong communication skills and ability to collaborate well with both interdisciplinary care team members and operational team members

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

$66,000 – $85,000 Annually

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Covid 19 Update – Please Read

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

Medical Clearance (for Member-Facing Roles)

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.