Chief Compliance Officer, Medicare Advantage Health Plan

5 days ago


Charleston, West Virginia, United States The French Group Full time
Job Summary

We are seeking a seasoned Compliance Executive to lead our Compliance division and drive strategic growth, oversight, and operational leadership of our health plan's Compliance program.

Key Responsibilities
  • Implement and continually refine the Compliance Program, developing and maintaining compliance-monitoring tools as regulatory/contractual obligations change.
  • Oversee and maintain compliance with contractual and regulatory obligations, State and Federal requirements, and develop strategic relationships with government agencies.
  • Ensure compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation.
  • Develop internal audit plans, conduct and document internal audits, and identify areas of non-compliance.
  • Establish and maintain a solid culture of compliance throughout the organization, developing Compliance training and education programs.
  • Manage external regulatory audits, organize, document, and participate in all external audits, and support external auditors.
Requirements
  • Bachelor's degree required, Master's degree and/or Law degree preferred.
  • 8+ years' experience in managed care with Medicare regulatory compliance experience, plus a minimum of 3 years in a senior management position.
  • ISNP experience strongly preferred.


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