drjobs Government Programs Regulatory Reporting Lead - Health Plan

Government Programs Regulatory Reporting Lead - Health Plan

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1 Vacancy
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Job Location drjobs

Sioux Falls, SD - USA

Monthly Salary drjobs

$ 32 - 52

Vacancy

1 Vacancy

Job Description

Sanford Health is one of the largest and fastestgrowing notforprofit health systems in the United States. Were proud to offer many development and advancement opportunities to our nearly 50000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Work Shift:

Varies (United States of America)

Scheduled Weekly Hours:

40

Salary Range: $32.50 $52.00

Union Position:

No

Department Details

This position can remote or in office. If remote some inperson attendance will be required for training team meetings or special projects. These onsite responsibilities will be scheduled in advance.

Summary

The Government Programs Regulatory Reporting Lead will serve as the subject matter expert for regulated reporting and audit readiness of the Government Program products including Medicare Advantage ACA and Medicaid to ensure we are meeting all State and Federal regulations and time frames and in accordance with Sanford Health Plans policies. This includes but is not limited to assisting with questions related to data submissions internal validations and other task as assigned.

Job Description

Manages reporting auditing and data exchange of the government programs Medicare Advantage ACA and Medicaid in support of business objectives. Works collaboratively with operational units to ensure the products are accurately defined communicated and configured; all member communications are compliant and data exchanges and reports are accurate timely and meet State and Federal requirements. Serves as the main point of contact for all reporting related questions issues and interpretation. Leads in the development implementation process improvement and education of the government program products. Leads in ensuring certifications quality reporting member materials and website content and regulatory and statutory standards and requirements are met. Carries out operational policies and procedures that support organizational improvements and comply with Federal and State requirements. Other special projects as assigned. Occasional travel required.

Qualifications

Bachelors degree in health care finance or a related field.

Minimum five years of relevant experience required. A background or experience in health care reimbursement or contract negotiations preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet.


If you are an individual with a disability and would like to request an accommodation for help with your online application please callor send an email to

Employment Type

Full-Time

Company Industry

About Company

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