Compliance Specialist

Research, analyze and interpret regulations relevant to Federal and State programs, and recommend enhancements to processes, policies, procedures and contracts for all business areas. Facilitate the implementation of regulatory policies for all populations, working closely with legal and all impacted business areas.

Research, analyze, and respond to client, regulatory agency, and internal requests for compliance information

Review new and revised regulations applicable to Medicaid and Medicare programs; compile data from reference material and use of various resources including Lexis/Nexis and the Internet; analyze the information and make recommendations regarding applicability to the enterprise and the company’s compliance status

Act as a resource to other departments regarding Medicare/Medicaid, HIPAA, and ERISA regulations

Work with business partners in fully understanding regulatory requirements and assist in identifying methods and alternatives for implementation into the enterprise environment

Develop, recommend, and document company-wide compliance policies, which include plan design and departmental procedures

Review and update provider communication relevant to regulatory issues

Job Specifications

Typically has the following skills or abilities:

Bachelor’s degree in Finance, Accounting, or Business Administration or related field; or equivalent experience

2+ years demonstrated knowledge of regulatory compliance policies and procedures in a managed care environment

Proven analytical and problem-solving skills

Excellent verbal and written communication skills

Excellent organizational and project input skills

Proficient with word processing and spreadsheet applications

Clean credit history as reported by credit report (for Finance division only)

Regularly exercises discretion and independent judgment in the performance of his/her job duties

Medicare and Medicaid experience

#LI-VISIONCARE

Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. 

Salary Ranges: $51,000.00 - $85,500.00

VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, gender identity, sexual orientation, disability or protected veteran status.  We maintain a drug-free workplace and perform pre-employment substance abuse testing.

Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. 

We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. 

As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees.  VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies. 

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