Manager, Compliance
Found in: Appcast Linkedin GBL C2 - 2 weeks ago
JOB SUMMARY
The Manager, Compliance - STAR+PLUS is responsible for managing and overseeing the HHSC STAR+PLUS program to ensure compliance with laws, regulations, and contractual requirements. This position requires in-depth knowledge of STAR+PLUS, including developing policies and procedures to comply with this Medicaid managed care program for adults with complex medical needs. The Manager will provide leadership, guidance, and education company-wide to ensure compliance with policies, procedures, and deliverables related to STAR+PLUS. Strong collaboration, communication, and interpersonal skills are required.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Compliance lead for developing, implementing, and evaluating company-wide effectiveness of STAR+PLUS program related functions.
Develop training material and conduct internal / external stakeholder training sessions as necessary.
Collaborate with internal operational areas on matters related to regulatory reporting, audits, and corrective action plans related to STAR+PLUS.
Develop, implement, and manage Compliance policies and procedures for STAR+PLUS and collaborate with the Policies and Procedures team to ensure accuracy of regulatory requirements and citations.
Analyze and evaluate information related to the healthcare regulatory environment by monitoring appropriate state, federal and industry channels, and participating in workgroups as applicable.
Monitor and assess compliance risks with state and federal regulations related to STAR+PLUS and develop strategies to mitigate risks. Timely and accurately communicate compliance-related information to operational areas, Director, and Chief Compliance Officer.
Other duties ass assigned.
QUALIFICATIONS:
Education/Specialized Training/Licensure: Bachelors degree in healthcare administration, business administration or related field required.
Masters degree in business or healthcare related field preferred.
Work Experience (Years and Area): 5-7 years of experience in healthcare compliance, with a focus on the STAR+PLUS program and managed care.
Experience working with regulatory agencies.
Management Experience (Years and Area): Minimum of 2 years of management, supervisory experience, leading projects and conducting training.
Software Proficiencies: Standard Office Software (Microsoft)
Other:
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