Contract Compliance Manager

Gainwell Technologies LLC•Any city, OH

3d•$108,500 - $155,000•Remote

About The Position

Responsible for the oversight of all contract compliance and audit activities including but not limited to any external audits required by contract, KPI Reporting, CMS Certification and the development and execution of any contract deliverables (Daily, Weekly, Monthly, Quarterly or Annual). Develop and coordinate contract monitoring performance standards and management reporting with State customer for fiscal agent contract. Responsible for oversight of contractual issues and follow-up required with State and Gainwell staff to resolve identified issues such as policy clarifications impacting claims processing; and timely completion of Corrective Action Plans. Track issue to closure and State-approval. Work with State and Gainwell Leadership on management areas to improve contract verbiage, reporting processes, monitor and report on SLA and KPI adherence and communication to impacted entities and staff. Meet with Fiscal Agent Contract Manager and State leadership on a periodic basis to highlight work completed, project status updates, and upcoming implementation schedules and planned communication for policy and system changes. Includes updates by other Gainwell Leaders as appropriate. Assist Account General Manager (AGM) and Client Delivery Leader (CDL) on Client References and statistics needed for new business pursuits for Gainwell. Provide contract performance and compliance monitoring of contract Performance Expectations. Train and re-enforce understanding of importance of contract compliance to new staff and leadership. Produce monthly status reports that outline activities and tasks performed by contract monitoring. Work directly with Security Compliance Gainwell staff to support secure operations and represent GAINWELL in Security Audits as the lead/or Co-Lead. Champion contract optimization and help plug gaps in contract. Recruits and supports development of direct staff member when applicable. Applies advanced subject matter knowledge to manage staff activities in solving common and complex business/technical issues within established policies. Provides guidance on process improvements and recommends changes in alignment with business tactics and strategy for area of responsibility. Protects the confidentiality, integrity, and availability of organizational and client data in accordance with regulations, standards, and best practices.

Requirements

Ability to build trust and positive relationships with leadership and staff within client and Gainwell, recognized as a valued resource for consultation by executive management.
Expertise in creating positive changes in how customers and the team perceive and achieve process improvement, customer relationships, and contract compliance.
Effectively leads, collaborates, builds relationships and influences team members to work toward common objectives across functions and groups.
Demonstrates seasoned judgment in business matters and leadership.
Results oriented; promotes accountability.
Routinely exercises independent judgment in developing methods, techniques and criteria for achieving multiple objectives.
Exceptional interpersonal communication skills (writing, listening, speaking, presenting) and fluent in English.
Bachelor’s/Master’s degree in accounting, Business Management, Computer Sciences, or equivalent.
At least 6+ years of Audit/Compliance experience preferred.

Nice To Haves

Healthcare or insurance industry experience is preferred.
Prior Medicare/Medicaid State experience is a plus.
Audit, Compliance, Lean Six Sigma certifications or other preferred training.

Responsibilities

Oversight of all contract compliance and audit activities including external audits, KPI Reporting, CMS Certification, and development/execution of contract deliverables.
Develop and coordinate contract monitoring performance standards and management reporting with State customer for fiscal agent contract.
Oversight of contractual issues and follow-up with State and Gainwell staff to resolve identified issues, including policy clarifications and timely completion of Corrective Action Plans.
Work with State and Gainwell Leadership on management areas to improve contract verbiage, reporting processes, monitor and report on SLA and KPI adherence, and communicate to impacted entities and staff.
Meet with Fiscal Agent Contract Manager and State leadership periodically to highlight work completed, project status updates, upcoming implementation schedules, and planned communication for policy and system changes.
Assist Account General Manager (AGM) and Client Delivery Leader (CDL) on Client References and statistics needed for new business pursuits.
Provide contract performance and compliance monitoring of contract Performance Expectations.
Train and reinforce understanding of the importance of contract compliance to new staff and leadership.
Produce monthly status reports outlining activities and tasks performed by contract monitoring.
Work directly with Security Compliance Gainwell staff to support secure operations and represent GAINWELL in Security Audits as the lead/or Co-Lead.
Champion contract optimization and help plug gaps in contract.
Recruit and support development of direct staff members when applicable.
Apply advanced subject matter knowledge to manage staff activities in solving common and complex business/technical issues within established policies.
Provide guidance on process improvements and recommend changes in alignment with business tactics and strategy for area of responsibility.
Protect the confidentiality, integrity, and availability of organizational and client data in accordance with regulations, standards, and best practices.