Senior Manager of Compliance overseeing compliance operations related to insurance regulations at Tokio Marine HCC. Leading a team to ensure adherence to regulatory standards and internal guidelines.
About the role
- Director overseeing regulatory compliance operations for Centene, ensuring adherence to laws and regulations. Collaborating with teams to implement compliance strategies and manage Medicare compliance.
Responsibilities
- Direct and oversee regulatory compliance operations to ensure fully compliance with all applicable laws and regulations for assigned products/services
- Oversee, administer, and implement various aspects of the Medicare Compliance program, including HPMS communication/regulation
- Ability to research and apply CMS, DOI, OIG, and HIPPA regulations to create processes and strategies while ensuring corporate compliance
- Coordinate and document Centene responses to CMS Request for Information/Response
- Provide guidance to various departments regarding compliance issues and ensure implementation of new compliance requirements with respect to regulatory and contract language
- Identify, evaluate and analyze the impact of CMS and Medicare regulatory issues and advise management concerning impact
- Partner with various departments to ensure that state and/or federal regulatory requirements are communicated and met
- Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures
- Ensure all Medicare products and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities
- Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations; ensure policies and procedures are updated according to CMS/contract requirements
Requirements
- Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience
- 7+ years of regulatory, compliance, operations, or related experience, preferably in a health care environment
- Advanced degree preferred
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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