Medical Compliance Review Liaison

Description
The successful candidate will be responsible for overseeing grievance and appeal reviews, as well as conducting cultural and linguistic reviews for our subcontractors to ensure alignment with our commitment to diversity and inclusion. This role will provide support to department on promoting health equity within our organization and in the community, ensuring fair and just access to healthcare services for all members.
Essential Duties and Responsibilities
Conduct thorough reviews of grievances and appeals submitted by members to ensure compliance with regulatory requirements and company policies
Ensure timely trainings for practitioners pertaining to grievances that are determined to be discriminatory
Evaluate the cultural and linguistic competency of subcontractors and provide recommendations for improvement to enhance service delivery to diverse populations.
Monitors accreditation, contractual, legal, and regulatory requirements for cultural and linguis...