Joseph Pass Email & Phone Number

Sacramento, Ca, Us

Sacramento, California, United States

• Led the Patient Cost Recovery Section’s (PCRS) Healthcare Operations Compliance (HOC) Program. • Review and evaluate processes performed within the Section to ensure compliance with State and Federal statutes, regulations, and departmental procedures. • Work closely with each SME within the Section to document areas of compliance and non-compliance, identify process improvement opportunities, and confirm that all steps of reviewed processes are completed accurately. • Document… Show more • Led the Patient Cost Recovery Section’s (PCRS) Healthcare Operations Compliance (HOC) Program. • Review and evaluate processes performed within the Section to ensure compliance with State and Federal statutes, regulations, and departmental procedures. • Work closely with each SME within the Section to document areas of compliance and non-compliance, identify process improvement opportunities, and confirm that all steps of reviewed processes are completed accurately. • Document any areas of risk and non-compliance and make recommended solutions to management.• Responsible for writing Policy Directives (PDs), Information Bulletins (IBs), and Operational Procedures (OPs) for the Financial Services Division. • Research and analyze State and federal statutes and regulations which support PDs, IBs and OPs, and track all draft documents through their formal routing processes while addressing stakeholder feedback and draft revisions. • Coordinate and facilitate all related meetings during the development of PDs, IBs, and Ops, track all documents to be drafted, and regularly update management on the status of such documents.• Collaborate with internal and external stakeholders on process improvements and provide training and technical assistance to impacted program areas and offer overall guidance and support to hospital staff. • Responsible for the more complex research assignments and providing updates and recommendations to management to mitigate identified risks. Show less

Rancho Cordova, Ca

• Prepare marketing and member materials as required by CMS regulations and health plans.• Assure accuracy of all documents and compliance with applicable CMS regulations and State regulations, and complete review approval checklist(s)• Submit documents to CMS via HPMS as required per CMS regulations• Submit MMP documents to agencies as required by CMS and State• Maintain current knowledge of CMS regulations about member and marketing materials and document submission… Show more • Prepare marketing and member materials as required by CMS regulations and health plans.• Assure accuracy of all documents and compliance with applicable CMS regulations and State regulations, and complete review approval checklist(s)• Submit documents to CMS via HPMS as required per CMS regulations• Submit MMP documents to agencies as required by CMS and State• Maintain current knowledge of CMS regulations about member and marketing materials and document submission requirements• Collaborate with health plans and corporate operational departments to identify and create materials and ensure appropriate document content• Create and maintain departmental policies and procedures to reflect changes in regulation and departmental processes• Create and maintain member and marketing material style guides to reflect regulatory updates to marketing requirements and departmental processes Show less

Rancho Cordova, California

• Research, analyze, and respond to clients, regulatory agencies, and internal requests for compliance information. • Review new and revised regulations applicable to Medicaid and Medicare programs, compile data from reference material and use various resources, including Westlaw, Lexis/Nexis, and the Internet. • Analyze the information and make recommendations regarding applicability to the business and the business's compliance status.• Act as a resource to other departments… Show more • Research, analyze, and respond to clients, regulatory agencies, and internal requests for compliance information. • Review new and revised regulations applicable to Medicaid and Medicare programs, compile data from reference material and use various resources, including Westlaw, Lexis/Nexis, and the Internet. • Analyze the information and make recommendations regarding applicability to the business and the business's compliance status.• Act as a resource to other departments regarding Medicare/Medicaid, HIPAA, and ERISA regulations. • Assist business partners in fully understanding regulatory requirements and identifying methods and alternatives for implementation into the business environment. • Develop, recommend, and document company-wide compliance policies, which include plan design and departmental procedures. • Review and update provider communication relevant to regulatory issues. Show less

Sacramento, California, United States

Managed and oversaw development and implementation of Compliance Management System, collaborating with Board of Directors and Senior Management to ensure regulatory adherence and minimize impact on business growth. Created and maintained compliance policies and procedures and ensured regular updates in accordance with regulatory changes. Ensured daily oversight of institution's BSA/AML/CDD program and controls, including risk assessments, audits, and exam responses. Monitored and reviewed… Show more Managed and oversaw development and implementation of Compliance Management System, collaborating with Board of Directors and Senior Management to ensure regulatory adherence and minimize impact on business growth. Created and maintained compliance policies and procedures and ensured regular updates in accordance with regulatory changes. Ensured daily oversight of institution's BSA/AML/CDD program and controls, including risk assessments, audits, and exam responses. Monitored and reviewed BSA/AML/OFAC alerts and filed CTRs and SARs. Conducted thorough research and effectively communicated complex compliance and legal matters to Senior Management and Board of Directors. Assessed, reviewed, and approved third-party relationships and contracts in collaboration with Senior Management and legal counsel. Monitored and reviewed contract renewals for thorough vetting.● Established and maintained the Consumer Complaint Program, promptly notifying relevant personnel of non-compliance incidents or modifications to address consumer complaint risks.● Collaborated with business units to implement new policies, procedures, controls, and training programs for ongoing compliance with applicable laws and regulations.● Collaborated with Senior Management, business units, and auditors to identify and mitigate program vulnerabilities, ensuring successful audits and exams.● Administered institution's privacy program, ensuring compliance with privacy laws and policies.● Approved release of non-public personal information. Show less