Manager, Government Program Compliance – Risk Adjustment
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Job Description
Compliance Manager focused on Government Program regulations and overseeing operational compliance. Collaborating with multiple teams to manage risks and ensure adherence to laws for HCSC.
Responsibilities:
- Evaluate Government Program (Medicare and Medicaid) regulations, guidance and contracts.
- Assess the risk these items present with respect to HCSC government contracts.
- Manage direct reports and provide oversight of operational compliance.
- Ensure adherence to federal/state/local laws, regulations, and contractual obligations.
- Develop policies, conduct monitoring, manage risk, and liaise with regulatory agencies.
- Identify risks and issues of noncompliance and develop mitigation strategies.
- Collaborate with Corporate Compliance and business personnel, as well as HCSC management and governmental agencies to implement controls and processes.
Requirements:
- Bachelor’s Degree and five (5) years’ experience in healthcare compliance OR nine (9) years’ experience in health plan, regulatory compliance or risk management.
- One year of leadership/supervisory experience.
- Experience communicating and building relationships with internal business units and/or various external governmental agencies.
- Strong critical thinking, risk assessment, and mitigation abilities.
- Ability to influence processes to achieve results.
- Excellent verbal and written communication skills.
- Ability to work independently and be a self-starter.
- Organizational, project management, analytical and decision-making skills.
- PC proficiency to include MS Teams, Word, PowerPoint and Excel as well as Workday.
Benefits:
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
- annual incentive bonus plan
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