Compliance Manager - Healthcare Industry Exp. Required

NO AGENCIES - PLEASE

Commonwealth Care Alliance, Inc. (CCA) is a not-for-profit care delivery system committed to providing integrated health care and related social support services. Created in 2003, CCA is a “consumer-governed” organization offering a full spectrum of medical and social services for people with complex needs covered under Medicaid and for those “dually eligible” covered by both Medicaid and Medicare, including: older adults (65+) individuals with serious physical, cognitive, or chronic mental illness children with special needs



CCA is organized as a "consumer-governed care system” to ensure that the empowered consumer voice is built into all of our activities.

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COMPLIANCE MANAGER

(Healthcare Industry Experience Required)



 

Position Summary

 

Position is responsible for development and implementation of a Medicare and Medicaid managed care compliance program. The program includes but not limited to:

 

 

 

Permanent Essential Duties and Responsibilities

 

·  Lead company-wide initiatives to implement regulatory requirements including but not limited to development of company-wide policies and procedures, education and training materials,  program manuals, tracking tools;

 

·  Manage all Medicare and Medicaid requirements related to core products of Commonwealth Care Alliance including Medicare Part D compliance;

 

·  Direct efforts with other department staff to translate and integrate requirements into daily health plan operations;

 

·  Lead efforts with internal departments in developing and updating specific policies and procedures, business workflows, and training materials to ensure all functional area activities reflect Medicare and Medicaid managed care program requirements; 

 

·  Company lead to ensure compliance throughout the organization and delegated arrangements.

 

 

Requirements

 

·  BA Degree required. Master’s degree in health care administration, public administration, public health or business administration is preferred.

 

·  3- 5 years of work experience in health care required.

 

· A background with managed care regulations (Medicare and Medicaid), health plan operations, and administrative service is strongly preferred. Experience with compliance programs also preferred.

 

 

TO APPLY FOR POSITION, PLEASE CLICK HERE: https://home.eease.com/recruit/?id=33612