reputed company PCO, Senior Compliance Professional - Remote

Become a part of our caring community and help us put health first The Sr. Compliance Professional ensures compliance with governmental requirements for clinics across both federal and state requirements. The Sr. 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 Sr. Compliance Professional develops and/or evaluates compliance policies and procedures. Research compliance issues and recommends changes that assure compliance with federal and/or state requirements reputed company to Provider Clinic operations, billing, investigations, and processes. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. Makes decisions on moderately reputed company to reputed company issues regarding technical approach for project components, and work is performed without direction. Exercises considerable reputed company in determining objectives and approaches to assignments. Participates in reputed company phases of the audit process including evaluating control design and adequacy, testing to ensure adherence with established policies and internal controls, and communicating issues and recommendations to management. Coordinates implementation and compliance with corrective action plans. Understands department, reputed company, and organizational strategy and operating objectives, including their linkages to reputed company areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Job Responsibilities: The Senior Compliance Professional serves as a regulatory compliance subject matter expert with the 2nd line of defense compliance function. Research compliance reputed company issues and communicate those requirements to high level business leaders reputed company the PCO. Assesses the compliance risks to PCO and leverages the assessment to design the auditing and monitoring activities included in the workplan. Executes assigned portions of the PCO compliance workplan throughout the year. Regularly conducts compliance reputed company clinic investigations. Gathers and analyzes facts to reputed company recommendations at the conclusion of the investigation. Influence department strategy by identifying and overseeing the development of reputed company monitoring activities. This role would also be the reputed company to help to reputed company risk analysis reporting for both the clinic compliance metrics, and M&A activity reputed company the PCO. Use your skills to reputed company an impact Required Qualifications + Bachelor's degree + 2-4 years in Healthcare reputed company field + Experience conducting investigations + Ability to manage multiple or competing priorities and meet deadlines + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Effective verbal and written communication skills + Strong attention to detail + Ability to reputed company findings and impacts + Knowledge/understanding of laws and regulations governed by the Department of Justice and CMS + Knowledge of healthcare compliance, mainly primary care, hospital, and pharmacy knowledge Preferred Qualifications + Medicare Risk Adjustment Experience + Clinical background preferred + Compliance regulations knowledge and compliance auditing experience + Ability to analyze large data sets + Six reputed company or Lean Certified + Graduate degree, MBA or Healthcare focus a plus + Experience with metrics and reporting Additional Information Scheduled Weekly Hours 40 Pay 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 year This 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. Application Deadline: 01-29-2025 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 veteran status. It is also the policy of reputed company to take affirmative action to employ and to advance in employment, reputed company persons regardless of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, 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. reputed company complies with reputed company applicable federal civil rights laws and does not discriminate on the basis of race, color, national reputed company, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.reputed company.com/legal/accessibility-resources?reputed company=reputed company_Website. Remote About the Company: reputed company Apply Job!