MetroPlusHealth is looking to ensure operational compliance with state and federal regulations, contractual obligations, and new policy guidance for integrated products like Medicaid Advantage Plus (MAP) and federal products like Medicare Advantage. The role will identify compliance risks through audits and monitoring, driving corrective actions and remediation, and ensuring compliance plans and training are accurate and updated.
Requirements
- Experience with integrated and federal products and services highly preferred.
- Experience in Microsoft Office suite products including Outlook, Excel, SharePoint, and MS Teams a plus.
Responsibilities
- Conduct auditing and monitoring activities as outlined in Compliance Work Plan, and as potential risks are identified.
- Contributes quality and timely data for the materials prepared for both the Internal Compliance Committee and Audit and Compliance Committee of the Board of Directors.
- Plays a critical role in driving the progress for corrective actions throughout the organization. Upon identification of non-compliance, provide support to business areas in conducting a root cause analysis and developing corrective actions.
- Conducts auditing and monitoring to ensure compliance with requirements.
- Coordinates the support for business areas in creating and updating monitoring metrics to assess continued compliance with regulatory requirements.
- Ensures proper investigation of regulatory compliance related issues.
- Review policies and procedures for adherence to regulatory and contractual requirements.
Other
- Certified Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP) certificates are preferred
- Bachelor’s degree required; and
- 3 years’ experience in compliance, product, or operational areas; or
- High school diploma/GED with 8 or more years’ experience in integrated and/or federal products; or
- A satisfactory equivalent combination of education, training, and experience.
- Advanced degree in public health, public policy, or public administration is preferred.
- High-level of skill in leading interdepartmental and cross-functional strategy development and project management.
- Experience leading multiple projects to ensure corporate deadlines and objectives are met.
- Excellent oral, written, analytical, and critical thinking skills.
- Must have the utmost integrity in the handling of discreet and confidential materials.
- Ability to manage multiple projects simultaneously.
