Regulatory Compliance Manager

2 weeks ago


Pittsburgh, United States LIFE Pittsburgh Full time

Job Type

Full-time

Description

Under the direction of the Director of Quality and Compliance, enforces and maintains federal, state, and local regulatory compliance and leads the organizations Compliance Program. Ensures LIFE Pittsburgh is operating within the CMS and Pennsylvania regulations for operating a PACE program, along with all other applicable laws and regulations. Leads the compliance program to include Part D fraud, waste, and abuse compliance along with various areas within the organization that involve the potential fraud and abuse. Investigates, reports, and addresses all alleged non-compliance and develops a Corrective Action Plan when areas of opportunity are identified. Will also assist with quality assurance and performance improvement activities including monitoring the provision of services provided by LIFE Pittsburgh.

Requirements

Candidate must possess a bachelor's degree in related field, 3-5 years' experience with interpreting/managing regulations (preferably in a healthcare setting) and demonstrated experience with leading a corporate compliance program including Medicare Part D administration.



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