Compliance Manager
Location: Providence, Rhode Island
Description: Neighborhood Health Plan of Rhode Island is hiring Compliance Manager right now, this position will be ordered in Rhode Island. For detail informations about this position opportunity kindly see the descriptions. Overview:
The Compliance Manager is responsible for assisting in the implementation of Neighborhood’s Corporate Compliance Program, Standards of Business Conduct and Fra! ud, Waste and Abuse Plan and to ensure compliance with contractual and regulatory requirements and corporate policies and procedures that govern business activities. The Compliance Manager is accountable for assisting with the day-to-day operations of the Corporate Compliance Program by developing and implementing compliance policies and procedures, effective lines of communication and education and training programs as directed.
Qualifications :
Required :
- Minimum of a Bachelor’s Degree or sufficient work experience to equal the degree
- Two to four years of regulatory or compliance experience
- Computer skills required ( Microsoft Office)
- Detail-oriented
- Superior written and oral communications required
- Excellent quantitative analysis skills required
- Ability to build and maintain relationships internally and externally
- Strong leadership skills required
- Ability to ! lead and manage in a cross-functional environment
- Abi! lity to work independently in a flexible environment
- Ability to conduct compliance monitoring and audit reviews
- Preferred detailed knowledge of Medicare Advantage regulations and experience with CMS Health Management Plan System ( HPMS)
- HIPAA and Privacy Knowledge
- Healthcare Compliance experience
Responsibilities include but are not limited to the following:
- Develops and maintains compliance policies and procedures that support the operation of the Corporate Compliance Program:
- Manages the day-to-day operation of the Corporate Compliance Program by collaborating with business owners to establish processes and controls to demonstrate compliance with laws, rules and regulations, contracts and other requirements;
- Manages the internal policy and procedure management process through administration of the Core Policy ! Team;
- Collaborates with operational departments to investigate and resolve compliance issues;
- Consults with the Corporate attorney as needed to resolve legal compliance issues;
- Manages systems for tracking and documenting reports of actual or potential compliance issues through the entire investigation process;
- Identifies potential areas of compliance vulnerability and risk through the development and implementing of formal risk assessments;
- Develops, implements and monitors corrective action plans for the resolution of identified compliance issues, and provides guidance on avoiding reoccurrences;
- Manages multiple projects in an efficient and timely manner;
- Develops and manages an effective compliance education and training program for employees and interested parties;
- Conducts routine compliance reviews and audits to identify and promptly respond to compliance issues and reduce the risk of future recur! rence;
- Reviews recent proposed activities by regulatory agenci! es to determine potential impact on the organization’s operations;
- Performs complex compliance research and regulatory analysis in order to monitor regulations and support business operations by recommending and implementing changes to internal company processes as needed to ensure compliance;
- Leads and participates in cross functional teams, workgroups and committees;
- Coordinate compliance reporting and oversees the collection of data and production of reports needed to meet regulatory, accreditation or legal obligations;
- Collaborates with the Corporate Compliance Officer to monitor the overall effectiveness of the compliance program and provides recommendations for improvement;
- Identifies areas of the business where there is a risk of non-compliance and develop policies to reduce that risk;
- Others duties and projects as assigned by the Corporate Compliance Officer.
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If you were eligible to this position, please send us your resume, with salary requirements and a resume to Neighborhood Health Plan of Rhode Island.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position starts available on: Fri, 26 Apr 2013 13:12:24 GMT