Compliance Specialist

Job Title: Compliance Specialist Target Compensation Range: $65,000 - $85,000/year, depending on the relevant qualifications and experience. About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: The Compliance Specialist will play a critical role in the develop and maintenance of Astiva's Compliance Program. In this role, the Compliance Specialist will support the daily operations of the Compliance Program, implement proper preventative compliance programs, investigating complaints and execute relevant policies and procedures to ensure all business units and activities meet state and federal regulations. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Collaborate with internal stakeholders on Compliance issues. Under the direction of the General Counsel/Compliance Officer, prepare reports, related analyses, and make recommendations to assist management in ensuring compliance and improvement of internal controls. Consult with the legal department and advise leadership and management on compliance matters. Develop and provide employee training on compliance policies, practices, and reporting systems. Ensure compliance with state and federal agencies by studying existing and new legislation and facilitating the compliance program Provide guidance and information by interpreting policies and procedures related to compliance issues. Conduct thorough investigations of sales allegations, identifying compliance concerns and documenting findings accurately. Track complaints in the Medicare Compliance database and link all relevant documents. Assist the Management team with internal reporting of complaints, including populating reports that demonstrate complaint volume and investigation statuses. Identify, investigate, and report compliance issues, irregularities, and violations. Maintain record of compliance activities. Communicate with government agencies. Assist in the preparation of compliance reports, including reports for the Board of Directors and Compliance Committee. Handle all compliance and ethics matters with sensitivity and maintain strict confidentiality of all work material and activities. Regular and consistent attendance Other duties as assigned EDUCATION and/or EXPERIENCE: Bachelor's degree, or equivalent career experience, required Two (2) years prior experience at a Medicare Advantage Organization or Prescription Drug plan Sponsor Knowledge of risk assessment concepts Demonstrated understanding of CMS Medicare Guidelines. Ability to work effectively and participate in a team environment. Ability to handle and prioritize multiple tasks simultaneously. Proficient in MS Word and Excel BENEFITS: 401(k) Dental Insurance Health Insurance Life Insurance Vision Insurance Paid Time Off

Created: 2026-03-05