Compliance Coordinator at MTM ensuring contractual compliance and monitoring Fraud, Waste, and Abuse. Collaborating with various departments and overseeing performance improvement plans.
Responsibilities
The Compliance Coordinator plays a vital role in ensuring MTM’s overall contractual compliance
Responsible for monitoring potential Fraud, Waste, and Abuse (FWA) by performing investigations
Facilitating member appeals and transportation provider appeals
Overseeing the performance improvement plan (PIP) process for transportation providers
Acts as a liaison and provides support to auditors during reviews
Help oversee Quality Improvement Plans, audits, and provider assessment reviews
Compiling records, reports, investigation results, and audit findings for external clients
Proactively identify, prevent, and report potential FWA to Leadership and external clients
Collaborate with other departments and provide education of protocols, processes and procedures
Requirements
High School Diploma or G.E.D.
Bachelor’s Degree or equivalent relevant experience
Experience managing multiple priorities and initiatives with stringent deadlines
Detail-oriented, thorough, and systematic/methodical approach to projects
Strong analytical and problem-solving skills
Strong project management and organizational skills
Basic to intermediate understanding of data base/system concepts and/or design
Ability to complete basic to intermediate data analysis and trending
Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint and SharePoint)
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