Chief Compliance Officer, Medicare Advantage Health Plan Hybrid

4 days ago


Virginia Beach, 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 in our Medicare Advantage Health Plan. As a key member of our Executive Leadership team, you will be responsible for developing and implementing a comprehensive Compliance program that ensures our organization's adherence to regulatory requirements and contractual obligations.

Key Responsibilities
  • Develop and maintain a robust Compliance program, including monitoring tools and procedures to ensure ongoing compliance with regulatory and contractual requirements.
  • Oversee and maintain compliance with State and Federal regulations, as well as contractual obligations.
  • Establish and maintain relationships with government agencies, including State and Federal agencies, to ensure compliance and address any audit findings.
  • Conduct internal audits to identify and correct areas of non-compliance, and develop a culture of compliance throughout the organization.
  • Manage external regulatory audits, including coordinating information requirements and ensuring timely delivery of documentation.
  • Develop and implement a master compliance auditing log, and disseminate written policies and procedures related to compliance activities.
  • Communicate audit progress and findings to executive leadership and the Board of Directors.
Requirements
  • Bachelor's degree required; Master's degree and/or Law degree preferred.
  • 8+ years of experience in managed care with Medicare regulatory compliance experience, and a minimum of 3 years in a senior management position.
  • ISNP experience strongly preferred.


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