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
Robust understanding of healthcare payer operations.
Experience in compliance program administration including risk assessments, policy creation, training, monitoring and reporting, audits and investigations
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.
Robust analytical and risk-based decision-making skills.