David H. Email & Phone Number

California, United States

Concord, California

Managed PPNorCal's Healthcare Compliance Program. Responsible for affiliate's Privacy Program. Developed, maintained, and trained on HIPAA Privacy Policies and Procedures to ensure staff compliance with current federal and state laws and regulations. Ensured retention of records and documents as required by law. Chaired Compliance, Quality, Risk Management (CQRM) Program. Ensured that the CQRM work plan and activities satisfy PPFA accreditation standards. Participated in annual health center site visits. Served as the main contact for the bio-waste management program. Monitored and responded to patient complaints.

Responsible for internal auditing of the health plan’s Utilization Management, Claims, Grievance and Appeals, and Provider Dispute Resolution departments. Measure turnaround times for timeliness as required by state regulations. Coordinate external audit requests from regulatory agencies to internal departments. Update and maintain corrective action work plans for various state audits or self-disclosed findings. Assist the health plan’s Compliance Manager and Director with ad hoc department requests. Investigate and report suspected FWA incidents and privacy incidents to DHCS. Coordinate internal department deliverables in preparation for routine and ad hoc audit requests from regulatory agencies such as the DMHC and DHCS. Facilitate departmental workgroups for delegate corrective action plans.

Rancho Cordova, California

Responsible for triaging regulatory requirements for multi-national clients. Assisted in implementing companywide training materials for Vision Service Plan’s Compliance Program. Supported the Health and Government Market SBU’s management team with multiple DMHC plan to plan filings and addressed various comment letters received from the state in a timely manner. Successfully completed audit of employee training to maintain net positive completion rate. Responsible for reviewing and editing Business Associate Agreements and Non-Disclosure Agreements to meet company standards. Supported both the Contracting Unit and the RFP Unit in meeting their deliverables by reviewing and determining applicability of various statutes/regulations.

Fairfield, Ca

Responsible for helping and implementing health plan growth initiatives, such as: the addition of mental health benefits to Medi-Cal managed care. Conducted internal employee privacy audits of employees’ workspaces to ensure the maintenance of HIPAA compliance as an organization. Coordinated regulatory filings with delegated entities in a timely manner. Assisted internal departments with corrective action plans requested by regulating agencies. Conducted trainings for newly hired employees. Attended quarterly stakeholder meetings in collaboration with regulatory agencies to learn about current provider fraud trends. Maintained consistent communication with DHCS contract manager via monthly meetings.

San Lorenzo

Appointed as on-site team leader to conduct client intake and assess needs of high school youths. Assisted students in custom developing personal career and higher educational goals by staging resume workshops, researching jobs and engaging volunteer opportunities. Develop individual navigation strategies for students to apply to colleges and scholarships. Help to create a youth friendly productive environment by collaborating with instructors, counselors and administrative staff.

Bachelor'S Degree, Political Science And Government

Political Science, Political Science And Government