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Providence Health & Services Compliance Commercial Consultant (Contracts) in Beaverton, Oregon

Description:

Providence St. Joseph Health is calling a Compliance Commercial Consultant (Contracts) position to one of our footprint states which are inclusive of Oregon, California or Washington. This position may work remotely to start and in 2022 may pivot to a hybrid model working a combination for in office and remote.

Apply Today! Applicants that meet the minimum required qualifications will receive a message from Modern Hire requesting for you to log in and complete the first stage of the interview process which is an essay / text format interview.

We are seeking a Compliance Commercial Consultant (Contracts) who will be responsible for:

  • Handling various aspects of regulatory compliance activities for commercial health plan business (individual, employer group, and ancillary product lines)

  • Evaluating new and existing state and federal laws and regulations in order to advise internal customers and advance the health plan's interests

  • Representing the Regulatory Compliance, Risk Management, and Government Affairs Department in internal implementation processes related to the health plan's legal obligations and new business initiatives

  • Serving in a support role for the Senior Manager Regulatory Affairs and as an internal subject matter expert to staff and leadership at PHP regarding regulatory requirements

  • Analysis of legal obligations and complex regulatory reporting requirements

  • Impacting PHP's legal and regulatory obligations as well as financial obligations to commercial Providence Health Plan customers.

Major Challenges:

  1. Managing new and innovative relationships between the health plan and external partners.

  2. Establishing effective relationships with internal PHP customers, state regulators, and federal regulators in order to facilitate plan-wide compliance activities.

  3. Working independently while managing multiple priorities efficiently and effectively, and fostering collaborative working relationships under sometimes challenging business conditions.

  4. Making sound decisions independently with recognition that those decisions can have significant legal and regulatory impacts to the Health Plan.

In this position you will have the following responsibilities:

  • Responsible for required filings with state regulators ensuring health plan compliance with transparency and market-related laws and regulations, including requirements of licensure

  • Evaluates new and existing state and federal regulations in order to advance the health plan's positions and implement compliance obligations

  • Functions as liaison between PHP and state and federal regulator staff as tasked by the Senior Manager Regulatory Affairs

  • Provides regulatory interpretations to Senior Manager Regulatory Affairs, management and staff at PHP

  • Represents Regulatory Compliance, Risk Management, and Government Affairs Department in internal and external implementation processes for the health plan's new business initiatives

  • Consults with internal and external legal counsel as needed to fulfill these duties

  • Provides orientation, training, and support to leadership and staff at PHP regarding regulatory compliance for commercial products

  • Collaborates with colleagues in the Regulatory Compliance, Risk Management, and Government Affairs department in a manner that fosters an effective working relationships and a positive work environment

Qualifications:

Required qualifications for this position include:

  • Bachelor's Degree - OR- Associate's Degree and 4 years in a related field

  • 5 years relevant health plan, compliance and/or legal experience -OR- experience in another regulated industry

  • 5 years' experience with two of the following: Process improvement, policy and procedure development, technical or legal 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

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

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.

About Us

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.

Schedule: Full-time

Shift: Day

Job Category: Compliance

Location: Oregon-Beaverton

Other Location(s): California, Washington, Oregon

Req ID: 323852

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