- We are looking for people who have experience in Medicare Advantage regulatory compliance roles particularly experience with high stakes CMS audits compliance program administration risk assessments monitoring and auditing corrective actions policy development FDR oversight and related Medicare requirements
Key Responsibilities:
- Experience in regulatory compliance roles for US healthcare with deep expertise in Medicare Advantage programs
- Experience participating in CMS audits for Medicare advantage
- HEDIS and STAR rating experience
- Medicare related regulations FDR oversight and audit requirements HIPAA
- Solid understanding of healthcare payer operations
- Experience in compliance program administration including risk assessments policy creation training monitoring and reporting audits and investigations
Additional Responsibilities:
- Experience in developing HIPAA compliant applications operational processes
- Experience working in cloud technologies and implementing controls for BPaaS scenarios
- Excellent communication presentation and interpersonal skills
- Ability to influence cross functional teams without direct authority
- Strong analytical and risk based decision making skills