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Providence Health & Services Compliance Specialist - Medicare I in Beaverton, Oregon


Providence St. Joseph Health is calling a Compliance Specialist - Medicare I to our location in Beaverton, OR.

In this position you will have the following responsibilities:

  • This position is responsible for monitoring plan-wide compliance results for PHA’s Medicare Advantage compliance requirements.

  • Responsible for gathering, interpreting and disseminating regulatory and compliance guidance.

  • Provides reports on a regulatory basis to the Director Medicare Compliance.

  • Responsible for day-to-day compliance support for key business areas.

  • Researches compliance findings and coordinates the development of corrective action plans.

  • Coordinates the submission, confirmation of approval and distribution of all marketing materials which require CMS approval; maintains all associated records.

  • Represents Regulatory Compliance, Risk Management and Government Affairs in key meetings.

  • Responsible for assisting key business areas in the implementation of compliance and regulatory guidance.


Required qualifications for this position include:

  • 2 years of relevant health plan, compliance and/or legal experience or experience in another regulated industry.

  • 2 years prior experience with one of the following: Process improvement, policy and procedure development, technical or legal writing, written customer communications.

Preferred qualifications for this position include:

  • Bachelor’s degree.

  • Strong knowledge of PHA's Medicare programs and related operations is preferred.

  • Familiarity with compliance requirements for Medicare programs.

  • Ability to effectively handle multiple priorities from numerous sources and work with minimal supervision.

  • Strong interpersonal and group communication skills.

  • Strong written communication skills and related editing and word processing skills.

  • Excellent analytical and problem solving skills.

  • Consistent attention to detail and accuracy.

  • Ability to interact with all levels of personnel.

  • Ability to educate and guide business areas in successfully implementing regulatory/compliance changes.

  • bility to work in a fast-paced environment with rapidly changing priorities, flexibility and a positive attitude

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 a full comprehensive range of benefits - see our website for details

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 Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. 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: Billing/Insurance

Location: Oregon-Beaverton

Req ID: 227682