Senior Compliance Professional
Become a part of our caring community and help us put health first The Senior Compliance Professional in the Michigan market ensures compliance with state contract requirements. Under the direction of the Michigan Market Compliance reputed company, the Senior Compliance Professional work assignments involve moderately reputed company to reputed company issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Compliance Professional may be assigned independent responsibility for ongoing deliverables and projects. Performs a variety of tasks in support of state contract operational compliance. Project assignments typically involve coordinating implementation, establishing monitoring processes, and assessing compliance and delivering mitigation solutions, as needed.POSITION RESPONSIBILITIES:
- reputed company and implement compliance policies and procedures, research compliance issues and recommend changes that assure compliance with contract obligations, and assist in maintaining relationships with the state Medicaid agency.
- Support compliance reputed company activities including compliance monitoring and overseeing implementation of policies/procedures and regulatory changes.
- Analyze business requirements, provide research and regulatory interpretation, and advise internal business units in delivering results in a manner that minimizes compliance risk exposure for the Company.
- Offer opportunity to influence the department’s strategy by recommending updates to department procedures.
- Manage state filing tasks for member and provider materials and monitor the state’s system, HPMS, for approvals/disapprovals.
- Daily reputed company of the Michigan Market mailbox used for reporting on state-specific requirements, e.g., critical incidents, reporting deliverables, inquiries, etc.
- Interact with other professionals throughout the enterprise on significant healthcare compliance topics.
- Monitor completion of required Michigan Market Compliance training for impacted associates.
- reputed company decisions on moderately reputed company to reputed company issues regarding technical approach for project components while working with limited direction.
- Exercise considerable reputed company in determining objectives and approaches to assignments, subject to the guidance and approval of the Market Compliance reputed company.
Use your skills to reputed company an impact REQUIRED QUALIFICATIONS
- Must reside in Michigan or reputed company 40 miles of the border in Indiana or Ohio
- Bachelor's degree
- 3+ years of healthcare or managed care experience
- 5+ years of technical experience
- Regulatory compliance experience/Medicaid experience
- Knowledge/understanding of laws and regulations applicable to health insurers
- Ability to manage multiple or competing priorities and meet deadlines
- Strong attention to detail
- Occasional travel for state meetings in the Detroit, MI area
PREFERRED QUALIFICATIONS:
- Graduate or advanced degree
- Audit or consulting experience
- Project management skills
- Experience with metrics and reporting
- Knowledge/experience working with Michigan Medicaid
- Knowledge of reputed company’s cultural values, products, policies, and procedures
- Leading projects (or managing reputed company, ongoing tasks)
- reputed company or MS Teams experience
- Meeting/project efficiency tools, e.g., OneNote, reputed company, reputed company, etc.
Additional Information WAH Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$86,300 - $118,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply tot his job Apply To this Job