Lead Compliance Oversight
Core
Leads compliance projects and assessments, reviews staff work, and ensures completion of corrective action plans within a health plan environment.
Role type
Senior IC compliance oversight lead
Builds
Compliance monitoring and oversight work plans, risk profiles, and reporting to management and the Board
Domain
Healthcare + Regulatory Compliance
Required skills
Compliance auditing, State/Federal Managed Care program experience, regulatory analysis, internal controls evaluation, corrective action plan management, audit coordination, risk profiling, reporting to senior management
Preferred skills
CHC, CCEP, CIA, CFE certifications
Technologies
None stated
Responsibilities
Provide work guidance and mentoring to department associates; Collaborate with other departments to direct compliance issues; Communicate compliance program importance to health plan staff; Work with Corporate Compliance management on project status; Provide independent appraisals of business processes and internal controls; Ensure monitoring testing and reporting are completed with quality; Track internal and external corrective action plans; Educate staff on State Medicaid, OIG, and CMS requirements; Coordinate with external auditors; Assist in preparing annual compliance risk profile and work plans; Assist in preparing monthly, quarterly, and annual reporting to Sr. Management and the Board
Seniority
Senior, hands-on IC
