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Compliance Manager (Medicare)

St. Louis, MO 63105

Post Date: 03/18/18 Job ID: 44486 Industry: Program Manager

This Fortune 500 client is a nation-wide leader in the healthcare services field and they pride themselves on their ability to provide a wide range of government sponsored healthcare programs; including a variety of insurance solutions. Currently, they are seeking a Compliance Manager who will be Design and implement programs, policies, and practices to ensure State and Federal program contract compliance, as well as with federal and state legal and regulatory requirements as it relates to Medicare compliance.

Responsibilities Include.
  • Ensure healthplan Polices and procedures are compliant (Federal & State)
  • Manage the compliance Staff and Reporting
  • Analyze Healthplan deliverables and identfy opportunities for improvement
  • Act as a liaison with State and/or federal agency staff in response to inquiries and requests for information. Interact with Corporate compliance staff, and serve as primary health plan liaison with the Corporate Special Investigations Unit related to fraud and abuse.
  • Audit healthplan procedures and processes to ensure regulatory compliance
  • Collaborate with Marketing Manager to ensure plan initiates are engaged.
  • Train all health plan staff in accordance with regulatory requirments.
Qualifications: Education/Experience: Bachelor's degree in related field. 4+ years of compliance/regulatory experience in a health care and/or managed care setting/organization. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.Medicare experience REQUIRED

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