Health Plan Services Consultant

Gallagher • Rolling Meadows, IL

1d

About The Position

At Gallagher Benefit Services, you’re a trusted partner to organizations navigating some of their most important people decisions. We help clients build better workplaces, where people feel supported, empowered, and inspired to thrive. Whether it’s shaping benefit strategies, designing wellbeing programs, or advising on workforce challenges, the work you do here creates meaningful change for businesses and the people who power them. We’re a community of bold explorers, trusted experts, and compassionate partners; working side by side to solve problems, and shape the future of work. Here, curiosity is encouraged, collaboration is second nature, and your ideas have room to grow. If you’re looking for a place where your contribution matters and where you can help build a better world of work; think of Gallagher.

This role is responsible for providing subject matter expertise on compliance in order to effectively support our clients.
Review, interpret and implement state and federal guidance, including Medicare Advantage, Medicaid, Federally Facilitated Exchange, and commercial insurance programs.
Support CMS mock program audits to evaluate Compliance Program Effectiveness across audited program areas.
Provide guidance to clients on compliance program activities such as risk assessment, compliance plan development, monitoring, auditing, delegating oversight, root cause analysis, and corrective action plans.
Oversee and administer ongoing audit and monitoring program(s) based on guidance, through project work and/or interim compliance assignments.
Provide feedback, draft and/or updates policies, procedures, and compliance documentation.
Support and mentor peers where applicable and drive work product based on project assignment.
Adhere to established corporate policies and procedures
Perform other duties, as necessary, to meet corporate objectives
Travel as required

Requirements

• Bachelor’s degree and a minimum of ten (10) years government, health care, pharmacy benefit management, compliance, or quality profession (equivalent combination of education and experience considered.)
• Must have strong Microsoft Office Suite skills. Advanced skills in Word, Excel, Access, and PowerPoint required
• Experience with Medicare, Medicaid, Commercial insurance, Federally Facilitated Exchange, and/or Healthcare Provider compliance standards required.
• Must have strong verbal and written communication skills.
• Individual should be detail oriented with strong organization, prioritization, and analytical skills with the ability to work independently.
• Must work well under tight timelines and adapt quickly to change in a fast-paced, team-oriented, and high-growth environment.

Nice To Haves

• Advanced degree or certification in audit, pharmacy or compliance discipline preferred

Responsibilities

• Provide subject matter expertise on compliance in order to effectively support our clients.
• Review, interpret and implement state and federal guidance, including Medicare Advantage, Medicaid, Federally Facilitated Exchange, and commercial insurance programs.
• Support CMS mock program audits to evaluate Compliance Program Effectiveness across audited program areas.
• Provide guidance to clients on compliance program activities such as risk assessment, compliance plan development, monitoring, auditing, delegating oversight, root cause analysis, and corrective action plans.
• Oversee and administer ongoing audit and monitoring program(s) based on guidance, through project work and/or interim compliance assignments.
• Provide feedback, draft and/or updates policies, procedures, and compliance documentation.
• Support and mentor peers where applicable and drive work product based on project assignment.
• Adhere to established corporate policies and procedures
• Perform other duties, as necessary, to meet corporate objectives
• Travel as required

Benefits

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave
• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees