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VP, Healthcare Compliance

Tacoma, WA 98402

Post Date: 03/18/18 Job ID: 44454 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 VP, Healthcare Compliance to ensure regulatory compliance with state and other government agencies related to the health insurance industry.

Position: Direct Hire

Location: Tacoma, WA

Similar positions: Compliance Director

Responsibilities of the VP, Healthcare Compliance:
  • Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures
  • Develop policies, procedures, and processes to comply with state law, federal law, contract requirements, and various standards
  • Manage and implement compliance programs; including fraud, abuse, and HIPAA
  • Conduct compliance audits and develop strategic corrective action plans
  • Develop relationships with state legislative policymakers and assist with development of state legislative public policy concerning state insurance, managed care organization, and Medicare/Medicaid
  • Analyze the effect of state legislative on the company; report to upper management and advise
  • Provide leadership regarding compliance issues and implementation of new compliance requirements

Requirements of the VP, Healthcare Compliance:
  • Bachelor s degree required; Master s or Law degree preferred
  • Must have 8+ years of compliance program management and contract experience
  • Extensive knowledge of state administrative code and regulations, state insurance laws/regulations; including managed care regulations
  • Experience with state and federal government agencies, accreditation bodies, participating provider agreements, HIPAA and Third-Party Administration (TPA) laws, credentialing regulations and prompt pay laws
  • Applicants must be currently authorized to work in the United States on full-time basis

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