Compliance Manager Medicare

Amerihealth Caritas•,

1d•Remote

About The Position

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. This is a remote position within the United States working East Coast hours.

Requirements

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
Must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required.

Nice To Haves

Extensive experience with CMS audits and comprehensive knowledge of DSNP contracts is highly preferred
Certified in Healthcare Compliance preferred

Responsibilities

Assists in the development of compliance methodologies and monitors the effectiveness of compliance-related processes
Assist 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
Ensure that local compliance-related issues and risks are reported
Conduct routine and ad-hoc compliance assessments/research
Assist in the training of local compliance associates
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