Compliance Officer

Job description / Role

• Overseeing and monitoring the implementation of the compliance program in accordance with Laws and policies of the various Regulatory Authorities
• Periodically revising the program in light of changes in the needs of the organization, and in the law and policies and procedures of Regulatory Authorities
• Developing, coordinating, and participating in a multifaceted educational and training programs
• Coordinating internal compliance review and monitoring activities, including periodic reviews of departments
• Provides reports on a regular basis, and as directed or requested, to keep the Board and senior management informed of the operation and progress of compliance efforts.
• Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify key issues.
• Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
• Acts as an independent review and evaluation body to ensure that compliance Issues/concerns within the organization are being appropriately evaluated, investigated and resolved.
• Coordinate ISO registration & certification activities and external surveillance audits. Develop and maintain all manuals, forms other documents as per the requirements of relevant ISO standards. Plan and perform Internal Audits of Company Systems in order to assure compliance with relevant ISO requirements and established and approved guidelines and procedures for Company’s business processes.
• Coordinate other certifications as required.
• Overseeing existing/ new project implementation and monitoring all project related KPIs. Ensuring all project developments and changes are reported in timely and profession manner to the management.
• Identification and resolution of issues related to the existing/ new projects in a timely and professional manner

Requirements

Essential skills and qualification requirements:
• Bachelor’s Degree
• Minimum of 3 years of relevant work experience in compliance, management of compliance programs and at least 1 years related to federal or state regulatory/compliance activities
• Skills and experience sufficient to identify potential issues within a variety of company department and business units
• Strong communication skills in Arabic

Desirable skills:
• Experience managing a Compliance Program for a health insurance or healthcare company
• Strong knowledge of managed care operations
• Familiarity with federal and state Medicaid and Medicare regulatory environment
• Professional work experience with or for federal and state agencies
• Knowledge of health insurance regulatory requirements
• Experience conducting complex compliance investigations

About the Company

IRIS HEALTH SERVICES LLC, is an ISO 9001:2008 and ISO 27001:2013 Certified Third Party Administration Service Company providing professional medical benefit and claims administration services.

IRIS HEALTH with the strength of its team, experience and expertise provides an unparalleled end to end claims management solution. It's not just about claims processing but rather about managing medical claims.

Our cutting edge software platform fundamentally changes the dynamics of managing medical portfolios. As a result, our Clients benefit from many features that provide unparalleled efficiency that includes managing your medical claims, trend analysis and monitoring.