Director Government Programs Compliance Officer

2 days ago

Lewiston, Idaho, United States Cambia Health Solutions Full time
About the Role

Cambia Health Solutions is seeking a highly skilled Director Government Programs Compliance Officer to join our team. As a key member of our Compliance team, you will be responsible for leading the company's Government Programs Compliance efforts, including Medicare Compliance efforts and Federal Employee Program compliance efforts.

Key Responsibilities
  • Direct the development and maintenance of comprehensive Medicare compliance structure within Cambia.
  • Provide direction, guidance, support, and oversight for day-to-day Medicare Compliance activities.
  • Direct activities necessary to assure compliant operation of Medicare Advantage and Medicare Part D contracts as well as MediGap products consistent with federal and Cambia regulatory requirements.
  • Direct the development and maintenance of the Federal Employee Program (FEP) compliance structure within Cambia, with responsibility for guidance, support, and oversight for FEP activities.
  • Prepare audit findings, corrective action plans, and reports to support compliance oversight.
  • Analyze new statutes and regulations to determine the operational impact to Medicare and FEP programs and verify they are implemented properly.
  • Oversee annual risk assessment and the successful development and implementation of an annual audit plan for the Medicare contracts and FEP products.
  • In conjunction with the Medicare line of business, oversee marketing and sales activities and materials to support Medicare and sales.
Requirements
  • J.D. or Master's degree in health care administration, public service administration, or related field.
  • Seven years of work experience in personnel management and compliance-related activities, legislative and regulatory activities, health insurance operations, or legal research, or equivalent combination of education and job-related work experience.
  • Leadership skills with a proven ability to provide responsive leadership, delegate, coordinate, and motivate staff, evaluate performance.
  • Superb judgment, problem-solving, analytical, cognitive, verbal, and written communication and presentation skills.
  • Knowledge of health plan and Medicare legislation and regulations, including government contract benefits policies and practices, rules, and regulations for Medicare products.
  • Ability to establish and maintain effective relationships with key external and internal stakeholders.
  • Ability to coordinate work with other company departments and teams.
  • Excellent verbal and written communication skills.
  • Ability to communicate effectively, both orally and in writing, with individuals and groups, regarding complex or sensitive issues or regulations.
  • Strong experience with Medicare health care products preferred.
  • Knowledge and experience in Medicare Compliance activities and in working effectively with CMS and key internal stakeholders in identifying, addressing, ameliorating, and preventing compliance concerns and problems.
  • Knowledge of government regulations as they relate to the administration of Medicare health care programs, particularly compliance, and principles and practices of managed care.
  • Ability in the area of project coordination and management.
  • Skills in research, writing, public speaking, and use of computer.
  • Knowledge of in-depth health plan operations, philosophy, history, procedures, and systems.
  • Health policy issues related to medical and other health care activities, including, but not limited to, health care finance and a broad range of health care public policy issues.
  • Health insurance, including state, federal, and managed care program requirements, with an emphasis on Medicare health care laws and regulations.
What We Offer
  • Competitive salary and generous benefits package.
  • Opportunity to work with a purpose-driven, award-winning culture built on trust and innovation.
  • Chance to grow your career with a company committed to helping you succeed.
  • Flexible work arrangements, including remote work options.
  • Comprehensive training and development programs.
  • Opportunities for professional growth and advancement.

  • Director of Government Programs Compliance

    3 weeks ago

    Lewiston, Idaho, United States Cambia Health Solutions Full time

    Job Title: Director Government Programs Compliance OfficerCambia Health Solutions is seeking a highly skilled and experienced Director Government Programs Compliance Officer to join our team. As a key member of our Compliance team, you will be responsible for leading the development and maintenance of comprehensive Medicare compliance structures within...

  • Pharmacy Director

    3 weeks ago

    Lewiston, Idaho, United States Parraway Recruitment Services Full time

    Job SummaryWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy department. The successful candidate will be responsible for overseeing the daily operations of the pharmacy, ensuring compliance with regulatory requirements, and providing exceptional patient care.Key ResponsibilitiesLead and manage the pharmacy department,...

  • Executive Director

    4 weeks ago

    Lewiston, Idaho, United States Senior Services Of America Full time

    Job SummaryThe Executive Director is responsible for overseeing the daily operations of a senior living community, ensuring the highest level of care and service for residents. This role requires strong leadership and management skills, as well as the ability to maintain a safe and secure environment.Key ResponsibilitiesAssume ultimate responsibility for the...

  • Pharmacy Director

    2 weeks ago

    Lewiston, Idaho, United States Parraway Recruitment Services Full time

    Pharmacy Director Job DescriptionAt Parraway Recruitment Services, we are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy department. As a key member of our healthcare team, you will be responsible for overseeing the daily operations of the pharmacy, ensuring the highest level of patient care and safety.Key...

  • Pharmacy Director

    3 days ago

    Lewiston, Idaho, United States vodastra Full time

    Pharmacy Director Job DescriptionWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy operations in a leading healthcare facility. As a senior-level professional, you will be responsible for enhancing patient care through effective pharmacy management and collaboration with medical staff.Key Responsibilities:Coordinate...

  • Pharmacy Director

    2 days ago

    Lewiston, Idaho, United States vodastra Full time

    Pharmacy Director Job DescriptionWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy operations in a leading healthcare facility. This senior-level position will focus on enhancing patient care through effective pharmacy management and collaboration with medical staff.Key Responsibilities:Coordinate pharmacy services...

  • Security Officer

    4 weeks ago

    Lewiston, Idaho, United States Allied Universal® Full time

    Job OverviewAllied Universal is a leading security and facility services company that offers rewarding careers that give you a sense of purpose. As a Security Officer, you will be part of a dynamic, diverse, and inclusive workplace that fuels a culture that reflects in our communities and customers we serve.We offer a comprehensive benefits package,...

  • Pharmacy Director

    1 month ago

    Lewiston, Idaho, United States Cross Country Healthcare Full time

    Pharmacy Director Job DescriptionWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy team and drive excellence in medication management and patient care.Key Responsibilities:Lead and manage the pharmacy department, including staff recruitment, training, and performance management.Develop and implement pharmacy policies and...

  • Pharmacy Director

    4 weeks ago

    Lewiston, Idaho, United States Thomas Talent Network Full time

    Job SummaryThomas Talent Network is seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy department. As a key member of our healthcare team, you will be responsible for overseeing all aspects of pharmacy operations, ensuring the safe and effective delivery of pharmaceutical services.Key ResponsibilitiesManage pharmacy operations,...

  • Pharmacy Director

    4 weeks ago

    Lewiston, Idaho, United States Elite Mente LLC Full time

    Job SummaryWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy team at Elite Mente LLC. As a key member of our healthcare team, you will be responsible for overseeing the daily operations of the pharmacy, ensuring the highest level of patient care and safety.Key ResponsibilitiesDevelop and implement pharmacy policies and...

  • Pharmacy Director

    6 days ago

    Lewiston, Idaho, United States UpLevel Sourcing, LLC Full time

    Job SummaryWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy department and drive exceptional pharmaceutical care. As a key member of our team, you will be responsible for coordinating services, managing policies, and overseeing personnel to ensure seamless pharmacy operations.Key ResponsibilitiesCoordinate Services:...

  • Pharmacy Director

    4 weeks ago

    Lewiston, Idaho, United States Parraway Recruitment Services Full time

    Pharmacy Director Job DescriptionWe are seeking a highly skilled and experienced Pharmacy Director to lead our pharmacy team at Parraway Recruitment Services.Key Responsibilities:Coordinate pharmacy services through effective communication with medical staff, nursing staff, and other hospital staff.Participate in committees such as Pharmacy and Therapeutics,...

  • Revenue Cycle Director

    3 hours ago

    Lewiston, Idaho, United States Catalyst Medical Group Full time

    Job SummaryThe Director of Revenue Cycle is a senior leadership position responsible for directing Patient Financial Services (Revenue Cycle) at Catalyst Medical Group. This role oversees the planning, implementation, and maintenance of all functions pertinent to the Revenue Cycle department, ensuring compliance with state, federal, and regulatory agency...

  • Senior Director Operations/General Manager

    3 weeks ago

    Lewiston, Idaho, United States CHS Inc Full time

    Senior Director Operations/GM Job SummaryCHS Inc. is a leading global agribusiness owned by farmers, ranchers, and cooperatives across the United States, providing grain, food, and energy resources to businesses and consumers worldwide. With 10,000 employees across 19 countries, we empower agriculture through connections.Key ResponsibilitiesLead the CHS...

  • Psychiatry Medical Director Opportunity in Lewiston, ID

    4 weeks ago

    Lewiston, Idaho, United States Archway Physician Recruitment Full time

    Medical Director Opportunity in PsychiatryWe are seeking a BC/BE Psychiatrist to serve as the Medical Director of our 20-bed adult inpatient unit in Lewiston, ID. As a Medical Director, you will be responsible for up to 10 hours of provider education, scheduling, and leadership per month. The schedule is 7 on/7 off, with a call ratio of 1:3 when fully...

  • Security Supervisor

    2 weeks ago

    Lewiston, Idaho, United States Lewis-Clark State College Full time

    Job Title: Security Officer, SupervisorLewis-Clark State College is seeking a highly skilled and experienced Security Officer, Supervisor to join our team. As a key member of our security department, you will be responsible for ensuring the safety and security of our campus community.Responsibilities:Assist with the development, planning, and implementation...

  • Transportation Security Officer

    3 days ago

    Lewiston, Idaho, United States Transportation Security Administration Full time

    Job SummaryAs a Transportation Security Officer with the Transportation Security Administration, you will play a critical role in ensuring the safety and security of the traveling public. You will be responsible for screening passengers and their belongings, as well as operating various security equipment and technology to identify potential threats.Key...

  • Senior Director Operations/General Manager

    3 days ago

    Lewiston, Idaho, United States CHS Inc Full time

    Senior Director of Operations/GM OpportunityCHS Inc., a leading global agribusiness, is seeking a seasoned Senior Director of Operations/GM to lead our Ag retail division. This exciting opportunity is based in Idaho and Washington, with the main headquarters in Lewiston, ID.Key ResponsibilitiesManage the business unit operation to provide patrons with...

  • Assistant Director of Marketing and Promotions

    2 weeks ago

    Lewiston, Idaho, United States Lewis-Clark State College Full time

    Job SummaryLewis-Clark State College is seeking a highly motivated and experienced marketing professional to join our athletic department as an Assistant Athletic Director of Marketing. This is an exciting opportunity to develop and execute marketing plans that increase visibility, attendance, and community engagement for our athletic programs.Key...

  • Pharmacy Department Head

    3 weeks ago

    Lewiston, Idaho, United States Top Tier Reps LLC Full time

    Pharmacy Director Job DescriptionTop Tier Reps LLC is seeking an experienced and highly skilled Pharmacy Director to lead their pharmacy department. The successful candidate will be responsible for overseeing all pharmacy operations, ensuring compliance with state and federal regulations, and managing a team of pharmacists and pharmacy technicians.Key...