Manager, Compliance – Duals & D-SNP Product
Job Description:
• Manage the Dual compliance department functions
• regulatory and D-SNP contract review and interpretation
• periodic monitoring and auditing activities based on established compliance program
• policies and practices to ensure and maintain compliance with regulations
• Manage approval and submission of timely and accurate D-SNP State Medicaid Agency contract and regulatory required report deliverables
• Oversee all SMAC updates including creating new and updating existing SMACs with CMS, Health Plans, States and consultants/vendors
• Conduct periodic assessments to ensure compliance against SMAC and regulatory requirements
• Oversee creation and implementation of corrective action plans to reduce or eliminate risk
• Collaborate with CMS, States, Product and Strategy
• Manage composition and delivery of inquiries and responses to state regulatory agency about D-SNP inquiries
• Support responses to “request for proposals” (RFPs) and new business implementations
• Participate in new Duals business implementations
• Design, implement and improve processes to prevent, detect and respond to compliance issues
• Create and deliver Duals compliance training for all employees on an annual basis and as needed basis
Requirements:
• Bachelor's Degree Health Care Administration, Compliance or related field or equivalent experience required
• 4+ years experience in compliance to include risk assessment against contract and regulatory requirements
• creation and execution of auditing, monitoring and reporting processes
• administration of correction action plans
• implementation of written policies and procedures
• developing and delivering compliance training and education required
• Experience with D-SNP SMAC, regulatory requirements and/or operations required
• Medicare managed health experience required.
Benefits:
• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules
Apply Now
Apply Now
• Manage the Dual compliance department functions
• regulatory and D-SNP contract review and interpretation
• periodic monitoring and auditing activities based on established compliance program
• policies and practices to ensure and maintain compliance with regulations
• Manage approval and submission of timely and accurate D-SNP State Medicaid Agency contract and regulatory required report deliverables
• Oversee all SMAC updates including creating new and updating existing SMACs with CMS, Health Plans, States and consultants/vendors
• Conduct periodic assessments to ensure compliance against SMAC and regulatory requirements
• Oversee creation and implementation of corrective action plans to reduce or eliminate risk
• Collaborate with CMS, States, Product and Strategy
• Manage composition and delivery of inquiries and responses to state regulatory agency about D-SNP inquiries
• Support responses to “request for proposals” (RFPs) and new business implementations
• Participate in new Duals business implementations
• Design, implement and improve processes to prevent, detect and respond to compliance issues
• Create and deliver Duals compliance training for all employees on an annual basis and as needed basis
Requirements:
• Bachelor's Degree Health Care Administration, Compliance or related field or equivalent experience required
• 4+ years experience in compliance to include risk assessment against contract and regulatory requirements
• creation and execution of auditing, monitoring and reporting processes
• administration of correction action plans
• implementation of written policies and procedures
• developing and delivering compliance training and education required
• Experience with D-SNP SMAC, regulatory requirements and/or operations required
• Medicare managed health experience required.
Benefits:
• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules
Apply Now
Apply Now