This role is responsible for monitoring CTS’ adherence to any federal and state regulations relevant to CTS operations. Additionally, will review CTS’ compliance with standards or regulations imposed by our contractual obligations and our own internal guidelines. This role will support CTS with company-wide audits, exclusion checks, and policy and procedure reviews/approvals.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Support CTS’ Medicaid/Medicare and OSTS non-emergency transportation (NET) compliance plan/programs
- Support the Compliance and Internal Audit department as outlined in CTS’ Compliance Plan
- Assist with annual review of Policies and Procedures (P&P), standardize wherever possible P&P’s with CTS clients.
- Provide monitoring and ongoing support to maintain company wide data integrity
- Serve as the secondary contact with government agencies or private health plans on Medicaid/ Medicare Compliance matters
- Assist Compliance Manager with internal audits
- Assist Compliance Manager in managing external audits (with resources provided by other appropriate departments)
- Utilize the P&P manual(s) as part of internal compliance audits to determine and support CTS companywide adherence to company and client procedures. In addition, work with Quality Assurance and the Training Manager to ensure compliance to the P&Ps.
- Assist in monitoring CTS subcontractors’ participation in compliance training that corresponds to CTS business standards and contractual requirements, including exclusion database verifications.
- Utilize third party software to manage CTS’ exclusion check process and perform checks on a monthly basis. Work with Human Resources and Provider Relations to update employees and providers that must be screened monthly.
- Raise recommendations to the Compliance Manager regarding the Compliance Program and suggest revisions to the compliance program due to changes to the needs of CTS and in the law, policies and procedures of contracted plans and/or government agencies
- Other special projects and/or duties as assigned
Education and/or Experience
High School Diploma required; College Degree preferred. Prior experience working in Compliance preferred. Experience in auditing preferred.
Must be proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook).
COVID Vaccination Required -Fully Remote Opportunity
CTS offers a competitive, performance based, salary and fringe benefits program. CTS is an equal opportunity employer
regardless of race, color, religion, creed, sex, marital status, national
origin, disability, age, veteran status, on-the-job injury, sexual orientation,
political affiliation or belief. Employment decisions are made without
consideration of these or any other factors that employers are prohibited by
law from considering