Compliance Manager Medicare

Role Overview

The Manager, Compliance provides support in the oversight of all operating division and subsidiary compliance functions and the implementation of compliance policy, process, and control activities. This position will monitor the execution of operational changes required by regulations and guidelines. The primary focus is on managing the audit team. Will work with internal audits, Medicare, and Medicaid, as well as regulatory audits.

Responsibilities

• Aids in the development of compliance methodologies and monitors the effectiveness of compliance-related processes
• Aids in the identification of gaps, weaknesses, and deficiencies and/or business productivity/efficiency opportunities
• Partners with local and corporate counterparts to review and assess objectives that ensure compliance with local plans and corporate policies and procedures
• Implements and monitors metrics and ensures accurate reporting of compliance information
• Ensures that local compliance-related issues and risks are reported
• Conducts routine and ad-hoc compliance assessments/research
• Aids in the training of local compliance associates

Requirements

• Must be able to operate independently with minimal management oversight and be able to manage competing priorities and deadlines that are subject to frequent change
• Must possess and exercise excellent professional judgment in all interactions

Qualifications

• Bachelor’s Degree in Business, Social Science, or relevant field required
• Minimum of 3 years in a managed healthcare environment, including experience in the areas of compliance oversight is a must
• Minimum of 3 years of supervisory experience is a must, as this role will have a team of 4-5 Analysts reporting to them
• Knowledge of compliance concepts and practices (strategies, control activities, information analysis, reporting, and communication)
• Strong analytical and research skills, able to synthesize information to provide practical solutions to accomplish meaningful results
• Self-motivated with demonstrated project management skills
• Extensive experience with CMS audits and comprehensive knowledge of DSNP contracts is highly preferred
• Certified in Healthcare Compliance preferred

Benefits

Our Comprehensive Benefits Package includes flexible work solutions including remote options, hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement, and more.