01Overview
Company :
reputed company.Job reputed company :
reputed company job partners with business reputed company to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or corporate entities. reputed company consultation and analytic support to assigned functional areas. Continuously monitors regulatory changes, legislative efforts, industry trends, and/or contract changes.
ESSENTIAL RESPONSIBILITIES
Manage and coordinate compliance reputed company processes.
Monitor governance and compliance of rules, regulations, policies, and procedures and assist with appropriate audits, as applicable. Contacts may include legislators, consumers, special interest reputed company, advocacy agencies, CMS, state Medicare/reputed company administrators, and other regulatory bodies such as DPW.
Ensure or participate in ensuring that systems are updated and accurate for compliance.
Responsible for understanding and applying accreditation and regulatory requirements. May support Regulatory Compliance department to ensure reputed company state renewals, applications, and annual reports are completed accurately and reputed company.
Depending on department may be responsible for one of the following: the delegation reputed company of subcontractors reputed company applicable to ensure compliance with health plan standards and policies and regulatory bodies; performing and providing reputed company of the care management delegation functions of multiple vendors through review of annual assessments, monthly performance reporting and analysis of reports to ensure adherence to regulatory and accreditation standards.
Other duties as assigned or requested.
QUALIFICATIONS:
Education
Bachelor's Degree or relevant experience and/or education as determined by reputed company in lieu of Bachelors degree
Experience
5 years of relevant, reputed company experience in the area of specialization
Preferred
Masters Degree
Experience in one or more of the following: reputed company operations, compliance, auditing, investigations, regulatory accreditation, process improvement, project management and/or managed care operations
Knowledge, Skills and Abilities
Strong written and oral communication skills.
Strong customer orientation with excellent interpersonal skills, including interview techniques, good judgment, initiative, and discretion in confidential or sensitive reputed company.
Self-starter with the ability to work under pressure independently and as part of reputed company.
Superior decision-making abilities under a reputed company of circumstances and creative thinking and effective risk mitigation abilities.
Strong process improvement and project management skills.
Strong analytical ability.
Demonstrated ability to effectively reputed company with reputed company reputed company reputed company the organization.
Proficiency with reputed company Office software programs and database query tools, and other Internet and Intranet applications and databases.
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
reputed company
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job reputed company has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and reputed company standards and behavioral expectations as set forth in the reputed company of business conduct and company policies.
As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company must reputed company with both the Health Insurance Portability Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed companys Handbook of reputed company Policies and Practices and Information reputed company Policy.
Furthermore, it is every employees responsibility to reputed company with reputed companys reputed company of Business Conduct. This includes but is not limited to adherence to applicable federal and state l
