Program and Policy Manager
Program and Policy Manager
Posted on :
07-06-2025
Employer Active
1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
07-06-2025
Job Description
Position Purpose
The Program and Policy Manager will be responsible for maintaining adherence to contract policy and compliance program requirements for the Cooperative as well as taking ownership of initiatives that support the department.
Essential Functions
The Program and Policy Manager will be responsible for maintaining adherence to contract policy and compliance program requirements for the Cooperative as well as taking ownership of initiatives that support the department.
Essential Functions
- Coordinate and monitor adherence to Compliance program policies. Take the lead on initiatives to ensure adherence including ongoing projects including but not limited to document retention and destruction compliance.
- Coordinate the submission of regulatory reporting including those submitted to Office of the Commissioner of Insurance (OCI) National Association of Insurance Commissions (NAIC) Internal Revenue Service (IRS) Centers for Medicare and Medicaid (CMS) and the State of Wisconsin Department of Health Services (DHS) to ensure critical deadlines are met.
- Act as primary liaison between the Compliance department and other interdisciplinary groups by interpreting policy and contract language and providing updated guidance as needed.
- Participate in vendor management process; schedule and prioritize vendor reviews and coordinate assessments.
- Participate in scheduled focused meetings with teams and vendors.
- Assist with scheduled and/or ad hoc internal or external audits or requests for information from contracted clients or regulatory bodies.
- Coordinate documentation for audits and site visits i.e. The National Committee for Quality Assurance (NCQA).
- Attend departmental or interdisciplinary meetings as needed to document discussions and create a record of initiatives.
- Ensure all projects are completed in a timely manner and meet required standards.
- Serve as the Business Owner of 1Password along with CEO and CFO.
- Serve as the Chair of the Diversity Equity Inclusion and Belonging (DEI&B) Committee.
- Serve as the back-up to Compliance Analyst: policy and procedure reviews monthly exclusion list checks for vendors and employees claims exception process and distribution of monthly training to all employees.
Minimum Requirements:
- Associate or Undergraduate degree.
- 2 years of work experience in a professional setting.
- Superior verbal and written communication skills.
- Strong analytical and research skills.
- Proficiency with MS Word Excel PowerPoint and Teams.
Group Health Cooperative of Eau Claire complies with applicable Federal civil rights laws and does not discriminate exclude or treat candidates less favorably on the basis of race color national origin (including limited English proficiency and primary language) age disability or sex (including sex characteristics including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes).
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration community involvement innovation and belonging. It is essential that all employees and members feel secure and welcome that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package including three weeks of vacation the first year a generous retirement plan health and dental insurance a wellness program and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration community involvement innovation and belonging. It is essential that all employees and members feel secure and welcome that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package including three weeks of vacation the first year a generous retirement plan health and dental insurance a wellness program and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
Required Experience:
Manager
Employment Type
Full Time
Key Skills
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