Manager, Compliance – Duals & D-SNP Product

Job Description: • Manage the Dual compliance department functions • regulatory and D-SNP contract review and interpretation • periodic monitoring and auditing activities based on established compliance program • policies and practices to ensure and maintain compliance with regulations • Manage approval and submission of timely and accurate D-SNP State Medicaid Agency contract and regulatory required report deliverables • Oversee all SMAC updates including creating new and updating existing SMACs with CMS, Health Plans, States and consultants/vendors • Conduct periodic assessments to ensure compliance against SMAC and regulatory requirements • Oversee creation and implementation of corrective action plans to reduce or eliminate risk • Collaborate with CMS, States, Product and Strategy • Manage composition and delivery of inquiries and responses to state regulatory agency about D-SNP inquiries • Support responses to “request for proposals” (RFPs) and new business implementations • Participate in new Duals business implementations • Design, implement and improve processes to prevent, detect and respond to compliance issues • Create and deliver Duals compliance training for all employees on an annual basis and as needed basis Requirements: • Bachelor's Degree Health Care Administration, Compliance or related field or equivalent experience required • 4+ years experience in compliance to include risk assessment against contract and regulatory requirements • creation and execution of auditing, monitoring and reporting processes • administration of correction action plans • implementation of written policies and procedures • developing and delivering compliance training and education required • Experience with D-SNP SMAC, regulatory requirements and/or operations required • Medicare managed health experience required. 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 Apply Now Apply Now