Compliance Program Manager Policy
Compliance Program Manager Policy
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Salary Not Disclosed
1 Vacancy
Job Description
Job Title: Compliance Program Manager (Policy)
Location: 100% Remote Role; French Camp CA
Duration: 12 Months Contract.
Interview process: Phone followed by Video Interview.
Work Authorization: U.S. Citizen or Permanent Resident Only.
Job Description:
NOTE: The client has requested a writing sample of a policy that the candidate has created. (Must provide)
Required experience:
- Minimum 5 years of recent experience as a Compliance Project or Program Manager (Policy) at a health plan.
- Experience of MediCal/Medicare/DSNP regulations compliance is a must.
- Compliance Program Manager (Policy) maintains oversight responsibilities of The Health Plans policy program and oversees related activities to ensure compliance with federal/state laws regulations and program standards.
Essential Functions:
- Creates updates and manages policies and procedures to ensure compliance with federal/state laws regulations and program standards.
- Conducts regular training sessions for staff to ensure proficiency in program processes and supporting systems.
- Assesses program performance and provides recommendations to the corresponding oversight committee.
- Ensures all policies and procedures are uptodate reflect the latest regulatory standards and update the programs policy guide and training materials accordingly.
- Coordinates conducts and documents compliance oversight activities.
- Develops and manages work plans to ensure activities and deliverables are completed accurately and on time; negotiates or resolves issues; escalates as needed.
- Guides internal and external stakeholders to ensure understanding and compliance with regulatory contractual and accreditation requirements and organization policies and procedures.
- Works collaboratively with external and internal customers to update and create new policies.
- Collaborates with internal and external stakeholders to conduct routine and adhoc internal and external audits; identifies deficiencies that require corrective action plans.
- Coordinates or manages the implementation of internal and external corrective action plans monitoring progress and completion coordinating interviews and document gathering and escalates as required.
- Analyzes and interprets regulations data and metrics to identify impacts risks opportunities trends variances and other insights.
- Compiles develops and submits reports with written summaries and recommendations to management and stakeholders including but not limited to operational issues process changes and activity status.
- Prepares reports and supporting documentation as the state NCQA and other regulators require.
- Serves as the primary point of contact for questions related to policy program processes
Employment Type
Full Time
