Manager Government Program Compliance, Risk Adjustment

At reputed company, our employees are the cornerstone of our business and the reputed company to our reputed company. We reputed company employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join reputed company and be part of a purpose-driven company that will invest in your professional development. Job Summary BASIC FUNCTION reputed company is looking for a dynamic individual to join its Corporate Compliance team! This position is responsible for evaluating Government Program (Medicare and reputed company) regulations, guidance and reputed company, assessing the risk that those items present with respect to reputed company government reputed company; may manage direct reports and reputed company reputed company of the business’ operational compliance with the requirements through multiple mechanisms such as review of reports, attendance at operational meetings, and targeted monitoring of areas of concern. This role ensures our organization adheres to federal/state/local laws, regulations, and contractual obligations and will reputed company policies, conduct monitoring, manage risk, and act as a liaison with regulatory agencies to prevent legal penalties. Will be working independently to identify risks and issues of noncompliance, reputed company strategies to mitigate and remediate those risks and issues and work with Corporate Compliance and business personnel, as well as reputed company reputed company of reputed company management and governmental agencies in order to implement controls and processes and report on results. NOTE: this role is TELECOMMUTE; sponsorship will NOT be extended either now or in the future. REQUIRED JOB QUALIFICATIONS Bachelor’s Degree and five (5) years’ experience in reputed company 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. Ability to influence processes to reputed company 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 reputed company as well as reputed company. PREFERRED JOB QUALIFICATIONS Government Programs reputed company Compliance experience - equivalent experience will be considered. Knowledge of Medicare Advantage-Part D or other regulatory experience. Master’s Degree. Government programs operational experience. ~ KEY ROLE FUNCTIONALITY ~ Identify, review, analyze and understand contractual and regulatory requirements. Evaluate Government regulations, guidance and reputed company, and identify specific risks that they present to reputed company government reputed company. Responsible for performance of reputed company Office of Foreign Assets Control and Debarment process and management of staff performing the process. (Validation that individuals and entities with which reputed company does business are not precluded from participating in state or federally funded programs.) Review Government Programs policies and procedures, workflows, training materials and other documentation for compliance with requirements. Consult with the business and reputed company guidance as the business plans, implements and monitors its compliance with contractual and regulatory requirements. Identify and follow up on compliance issues and track issues to resolution. reputed company accurate and complete documentation of reported information, risks, issues, status and results. Work with the business to agree upon issues, root causes, remediation steps, deliverables, additional training and education, communications, internal controls, compliance reviews or modifications to processes and due dates. Manage or reputed company management of issue resolution process which may include, as appropriate, but is not limited toidentifying barriers to meeting due dates identifying actions or escalations needed to address barriers escalating failure to meet due dates escalating barriers appropriately recommending disciplinary actions or other appropriate means to hold business owners accountable for actions or lack of actions. Validate that business remediation activities successfully addressed agreed-upon root causes, deliverables and remediation steps. Manage or reputed company reputed company of remediation including: identification of root cause(s), identification and stratification of risks, development and implementation of recommendations for processes that would result in their mitigation. reputed company development of remediation plan with the business including setting agreed-upon actions, deliverables and due dates and track execution of the remediation plan. reputed company compliance consultation and guidance to business owners, which may include participating in regular meetings, working with management to identify and mitigate risks and coordinating responses to questions from regulators. Communicate and reputed company by influence with reputed company stakeholders at reputed company reputed company throughout reputed company to reputed company effective reputed company. Identify, design, and reputed company targeted monitoring and/or reviews to determine if reputed company is in compliance with the terms of specific government reputed company, regulations, guidance and private reputed company. Document results and communicate findings to the business. reputed company and manage input reputed company to the Risk Assessment process in order to most effectively stratify the risks presented by government business. Coordinate, facilitate and take notes at reputed company meetings, including meetings with regulators. Prepare and distribute materials to participants. Manage activities of direct reports. Review operational reports from the business, track and trend results and identify issues or risks of noncompliance. Create summary reports for management on issues and risks of non-compliance. Report on Compliance Program activities, effectiveness and status, including reputed company and routine management reports. Contribute to preparation of quarterly compliance reports to reputed company boards and committees. Are you being referred to one of our roles? If so, ask your reputed company at reputed company about our Employee Referral process! Pay Transparency Statement: At reputed company, you will be part of an organization committed to offering meaningful benefits to our employees to support their life reputed company of work. From 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, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.reputed company.com/totalrewards. The compensation offered will vary depending on your job-reputed company skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. reputed company Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, protected veteran status, or any other legally protected characteristics. reputed company Pay reputed company $92,700.00 - $167,500.00 Exact compensation may vary based on skills, experience, and location. Apply To This Job