Experience

Truepill

• United States
• Software Development
• 200 - 300 Employee

• Compliance Generalist

  • Mar 2021 - Present

  California, United States ● Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness. ● Develops policies and procedures to conform to relevant state, federal, and/or industry standards and requirements and coordinate efforts with appropriate departmental staff to ensure implementation, with duties including… Show more ● Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness. ● Develops policies and procedures to conform to relevant state, federal, and/or industry standards and requirements and coordinate efforts with appropriate departmental staff to ensure implementation, with duties including but not limited to: Supporting consistency in policy content and format throughout the organization; ● Establish project plans, gap analysis, milestone dates, and other significant aspects, and leadership updates. ● Maintain knowledge of laws, regulations, company strategies to assess impact, and consult with clients as subject matter expert. ● Conducts complex investigations, document findings, and ensure corrective actions are made. ● Interface with external clients, regulators, vendors, suppliers; internal stakeholders, as required. ● Participate in audits and monitoring of systems and processes to ensure compliance of healthcare operations, including, but not limited to credentialing, insurance coverage, billing, etc. ● Perform annual HIPAA Security Risk Analysis (SRA), collaborating with business units and IT to ensure completion and follow through on corrective action plans. ● Track and Monitor the timely initiation and completion of individual department oversight audits; Ensure implementation and completion of any required corrective action plans. ● Manage regulatory filings, Board of Pharmacy applications, Medicaid, and PBM applications ● Oversee the Compliance Department’s periodic (i.e., monthly, quarterly, annually) regulatory report submission process ● Proactively monitors, applies and disseminates current/new federal and state laws and regulations in compliance, anti-fraud and privacy and security requirements Show less



The Premier Family of Companies

• Compliance Manager

  • Sep 2020 - Mar 2021

  Clearwater, Florida, United States ● Perform initial review of submissions and evaluate completeness, accuracy and appropriateness of proposed requests ● Prepare and file new company licensing where applicable ● Monitor and renew company licenses currently in place ● Manage business insurances (E&O; D&O; EPL; Work Comp; Property; Crime; Cyber; Gen Liab) ● Research procedures, interpret laws and statutes, and designate timelines for all licensing ● Renewal and update all Government-required… Show more ● Perform initial review of submissions and evaluate completeness, accuracy and appropriateness of proposed requests ● Prepare and file new company licensing where applicable ● Monitor and renew company licenses currently in place ● Manage business insurances (E&O; D&O; EPL; Work Comp; Property; Crime; Cyber; Gen Liab) ● Research procedures, interpret laws and statutes, and designate timelines for all licensing ● Renewal and update all Government-required bonding ● Coordinate responses to alleged compliance infractions or objections ● Claim audit ● Communicate with regulatory agencies and trade associations on matters involving regulatory compliance ● Act as a liaison with internal departments, subsidiaries, and third-party administrators to enhance understanding of compliance and regulatory requirements ● Develop and maintain effective formal and informal relationships with internal and external teams ● Identify and escalate potential areas of vulnerability and risk ● Collaborate across internal business departments to report compliance issues or to support investigations and resolution ● Track all agencies licensing deadlines ● Special projects and various other duties as needed Show less



ZeroIn Software Corp

• Software Quality Assurance Tester

  • Nov 2017 - Sep 2020

  California, United States ● Participate in analyzing the user/business requirements, functional specifications and use case documents ● Follow system development life-cycle (SDLC) process ● Involving in project planning and implementing QA methodology, create the detailed test cases and executing it ● Involving in Smoke, Integration, Functional, Regression, Exploratory and Production testing. ● Interact with developers and business Users to communicate the defects and actively participated in replicating… Show more ● Participate in analyzing the user/business requirements, functional specifications and use case documents ● Follow system development life-cycle (SDLC) process ● Involving in project planning and implementing QA methodology, create the detailed test cases and executing it ● Involving in Smoke, Integration, Functional, Regression, Exploratory and Production testing. ● Interact with developers and business Users to communicate the defects and actively participated in replicating the bugs and performed regression testing using JIRA ● Perform cross-browser functionality testing for web application ● Interact with the development configuration and operation's team to ensure the quality of software ● Verifying the integration of various components in the application and executed end-to-end testing ● Participated in various meetings and discussed Enhancements and Modification Request issues ● Participated in Release Review/Requirement Analysis and Design review meetings. ● Perform regression testing on fixed issues and for regular releases Show less



AmeriLife

• United States
• Insurance
• 700 & Above Employee

• Licensing Manager

  • Sep 2017 - Sep 2020

  United States *Process New Career Agents *Review/scrub career contracting paperwork received from agencies for completeness. *Pay appointment fee to the carriers. *Manage weekly/monthly reports such as Active agent report, Ready to sell report *Create and maintain agent record in VUE and ImageNow as needed. *Follow-up, via phone and/or email as necessary, with agency staff for any outstanding items: missing signatures, letters of explanation for any “yes” answers to background questions… Show more *Process New Career Agents *Review/scrub career contracting paperwork received from agencies for completeness. *Pay appointment fee to the carriers. *Manage weekly/monthly reports such as Active agent report, Ready to sell report *Create and maintain agent record in VUE and ImageNow as needed. *Follow-up, via phone and/or email as necessary, with agency staff for any outstanding items: missing signatures, letters of explanation for any “yes” answers to background questions, missing forms, etc. *Support via phone and/or email to get registered with MA carriers (Aetna, Humana, Wellcare, Healthspring, AARP/UHC and others.) *Research and verify licenses, CE Compliance, and Vector on websites. *Create/distribute Termination of Appointment letters as necessary. *Prepare/process electronic contracts from vendor/carrier website(s). *Provide support to General Managers and agency staff as it pertains to getting agents contracted with carriers. *Maintain New Agent Production spreadsheet. *Follow-up, via phone and/or email as necessary, with agency staff for any outstanding items: missing signatures, letters of explanation for any “yes” answers to background questions, missing forms, etc. *Process agent transfers from agency to agency ensuring that appointments and commissions are re-assigned correctly and promptly. *Work on additional tasks/projects as assigned by supervisor Show less