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Boston, Massachusetts, United States KPMG-UnitedStates Full timeSenior Manager, Tax Compliance at KPMGAre you interested in advancing your career with a prestigious firm like KPMG, recognized for its outstanding workplace culture and opportunities for professional growth?We are in search of a Senior Manager to join our Finance and Accounting team. This position entails supervising individual income tax compliance,...
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Senior Manager, Tax Compliance
17 hours ago
Boston, Massachusetts, United States KPMG-UnitedStates Full timeSenior Manager, Tax Compliance at KPMGAre you interested in advancing your career with a prestigious firm like KPMG, recognized for its outstanding workplace culture and opportunities for professional growth?We are in search of a Senior Manager to join our Finance and Accounting team. This position entails supervising individual income tax compliance,...
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Senior Compliance Officer
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Senior Safety Manager
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Boston, Massachusetts, United States Commonwealth of Virginia Full timeTitle: Senior Export Control Analyst Agency: Commonwealth of Virginia Location: Not Specified FLSA: Exempt Hiring Range: Not Specified Employment Type: Not Specified Job Overview: The Senior Export Control Analyst plays a crucial role in managing and overseeing the export control compliance program within the Commonwealth of Virginia....
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Senior Housing Compliance Manager
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Senior Auditor, Internal
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Compliance Associate
2 months ago
Boston, United States Fanning Personnel Full timeCompliance Associate opening located at a wealth management firm in BostonI’m a Senior Recruiter at Fanning- Masis. Since 1968, we have been assisting our client companies, investment firms in and around Boston, with their candidate recruitment process. This scenario has enabled us to serve as a valuable resource to an individual who may be actively or...
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Compliance Associate
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Boston, United States Fanning Personnel Full timeCompliance Associate opening located at a wealth management firm in BostonI’m a Senior Recruiter at Fanning- Masis. Since 1968, we have been assisting our client companies, investment firms in and around Boston, with their candidate recruitment process. This scenario has enabled us to serve as a valuable resource to an individual who may be actively or...
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Boston, Massachusetts, United States Resource Informatics Group Inc Full timePosition OverviewWe are seeking a Senior Compliance Business Analyst with a strong background in Calypso implementation. The ideal candidate will possess extensive experience in both analysis and testing within the Calypso environment.Key Responsibilities:• Facilitate sessions to gather business requirements, ensuring a comprehensive understanding of...
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Regulatory Compliance Specialist
5 days ago
Boston, Massachusetts, United States Cardea Group Full timeRegulatory Compliance Specialist: Cardea Group is in search of a dedicated professional to enhance our compliance framework in a newly established role. This position will report directly to the Chief Compliance Officer, providing the successful candidate with the opportunity to collaborate closely with all team members and engage with various facets of our...
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Compliance Associate
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Compliance Operations Coordinator
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Regulatory Compliance Specialist
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Boston, Massachusetts, United States Cambridge Associates LLC Full timeCareer Opportunity:Cambridge Associates LLC is seeking a dedicated Compliance Associate to become an integral part of our team, working closely with our Chief Compliance Officer and Compliance Director. The ideal candidate will be instrumental in overseeing employee reporting, facilitating online compliance training, and managing anti-money laundering...
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Compliance Associate
2 months ago
Boston, United States Cardea Group Full timeCompliance Associate (Boston, MA): Our client, a forward-thinking hedge and venture capital fund with over $10B in AUM, is seeking a proactive and motivated individual to support the firm's compliance program in a newly created position. Reporting into the Chief Compliance Officer, this new hire will gain exposure and access to all members of the team and...
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Compliance Associate
2 weeks ago
Boston, United States Cardea Group Full timeCompliance Associate (Boston, MA): Our client, a forward-thinking hedge and venture capital fund with over $10B in AUM, is seeking a proactive and motivated individual to support the firm's compliance program in a newly created position. Reporting into the Chief Compliance Officer, this new hire will gain exposure and access to all members of the team and...
Senior Compliance Professional
2 months ago
Humana Senior Compliance Professional - Boston, Massachusetts
Become a part of our caring community and help us put health first
The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Compliance Professional's primary focus will be to develop and implement a plan to monitor and audit business processes to prevent, detect, and resolve compliance issues to help ensure an effective compliance program for Claims, COB (Coordination of Benefits), Subrogation, and Provider Payment Integrity for the Medicare line of business.
The Senior Compliance Professional develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Key responsibilities may include:
Research, understand and apply laws, regulations, and regulatory guidance for Claims, COB (Coordination of Benefits), Subrogation, Provider Payment.
Serve as the subject matter expert on Claims, COB (Coordination of Benefits), Subrogation, Provider Payment Integrity.
Develop audit methodology and perform auditing and monitoring activity to prevent and detect issues of noncompliance and provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations.
Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, and Enterprise Compliance associates and leaders with regard to Claims, COB (Coordination of Benefits), Subrogation, Provider Payment Integrity.
Develop and track compliance metrics to help monitor and detect potential compliance issues.
Partner with Enterprise Compliance team members on regulatory outreach.
Serve as the Regulatory Compliance subject matter expert during CMS program audits.
Lead onsite program audit preparation and activity and perform oversight of business audit preparation to ensure timely, accurate and complete submission of required data and documentation to regulators.
Present findings of monitoring and auditing efforts to business partners and Enterprise Compliance leaders and track issue to ensure appropriate and timely remediation.
Lead and participate on committees, providing compliance guidance and direction.
Provide back-up and support to other Enterprise Compliance team members and perform other duties, as needed.
Use your skills to make an impact
Required Qualifications
5 or more years of technical experience
Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS
Preferred Qualifications
Graduate or advanced degree
Audit or consulting experience
Experience with metrics and reporting
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