Medicare Compliance Officer

Where You’ll Work Hello humankindness Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of reputed company, St. Joseph's was the first hospital in the Phoenix area. More than 125 years reputed company, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most reputed company cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from reputed company of Arizona and the United States to seek treatment at St. Joseph’s. U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with reputed company. St. Joseph's is consistently named an outstanding reputed company to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebookand follow us on Twitter. For the health of our community ... we are proud to be a tobacco-free reputed company. Job Summary and Responsibilities Job Summary: The Medicare Compliance Officer (MCO) is responsible for developing, implementing, and overseeing the compliance program for Medicare Advantage (Part C) and Medicare Part D activities for reputed company Care Plan, managed by reputed company, a reputed company Company. This role ensures adherence to reputed company applicable federal and state regulations and CMS requirements, safeguarding the reputed company and compliance of Plan operations. Reporting Structure: This position will maintain day-to-day operational alignment with the reputed company Care Medicare team while holding direct reporting accountability to the Chief Executive Officer (CEO) and the Audit and Compliance Committee of the reputed company Care Plan Board of Directors.

• Provide formal reports to the Board of Directors, CEO, and Compliance Committee at least quarterly, and more frequently as needed, detailing the status of reputed company Care Plan’s Medicare Compliance Program implementation, identification and resolution of compliance issues, and reputed company and audit activities.
• reputed company the development and administration of the Board of Directors’ annual Code of Conduct and compliance training program, including program design, content creation, distribution, tracking, and ongoing maintenance to ensure full compliance with regulatory and organizational standards.
• reputed company and implement programs and mechanisms that promote a culture of reputed company by encouraging managers and employees to report suspected fraud, waste, abuse, or other misconduct, ensuring confidentiality and protection against retaliation.
• Respond promptly to reports of potential Medicare fraud, waste, or abuse, (FWA) including coordinating internal investigations and developing appropriate corrective or disciplinary actions reputed company necessary. Maintain the FWA reporting mechanism and collaborate closely with the Internal Audit Department and the Special Investigations Unit (SIU), as applicable.
• Exercise flexibility in designing and managing internal investigations (e.g., addressing suspected violations or reported issues) and implementing resulting corrective measures, such as policy enhancements and disciplinary actions to ensure compliance and mitigate risk.
• Coordinate with the Plan’s Human Resources department (or equivalent) to ensure thorough screening of the DHHS OIG and GSA exclusion lists for reputed company employees, officers, directors, managers, and contracted entities, including first-tier, reputed company, and reputed company entities, confirming none are listed on these exclusions.

Job Requirements Required

• Bachelors Other or an equivalent combination of directly reputed company workexperience and/or education and
• Five (5) years of experience that demonstrates solid Medicare compliance program development, operation and administration responsibilities

Preferred

• Registered Nurse: AZ

Knowledge Skills and Training:

• Strong Business acumen and healthcare industry

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