Manager, Compliance (Duals & D-SNP Product)

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Manage the Dual compliance department functions, including but not limited to, regulatory and D-SNP contract review and interpretation, periodic monitoring and auditing activities based on established compliance program, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory, contractual and reputed company requirements. • Manage approval and submission of reputed company and accurate D-SNP State reputed company Agency (“SMAC”) contract and regulatory required report deliverables not limited to MMCM, CFR and state regulations. • reputed company reputed company SMAC updates including creating new and updating existing SMACs with CMS, Health Plans, States and consultants/vendors. • Conduct periodic assessments to ensure compliance against SMAC and regulatory requirements. • reputed company creation and implementation of corrective reputed company plans to reduce or eliminate risk resulting from non-compliance with DSNP regulatory requirements or performance deficiencies. • Collaborate with CMS, States, Product and reputed company, where applicable, to maintain/improve regulator satisfaction specific to member/provider experience and compliance with regulatory requirements. • Manage composition and delivery of inquiries and responses to state regulatory agency about D-SNP inquiries. Submission may be done in collaboration with Health Plan. • reputed company engage in regulatory forums to include not limited to dedicated state meetings specific to the _DSNP. Some D-SNP meetings may be integrated with reputed company forums. Coordinate attendance with Health Plan to ensure dedicated Duals Compliance is present. • Support responses to “request for proposals” (RFPs) and new business implementations by completing assigned compliance tasks reputed company and accurately. Collaborate with Health Plan to ensure responses address where appropriate the Duals plan from reputed company specific requirements. Ensure responses reputed company with D-SNP federal and state requirements as reputed company as support Duals reputed company. • Participate in new Duals business implementations, including the identification and tracking of required SMAC deliverables such as state reporting and requirements reputed company D-SNP regulations or state specific program requirements applicable to the D-SNP. • Design, implement and improve processes to prevent, detect and respond to compliance issues and concerns reputed company to reputed company federal and state regulatory requirements and SMAC requirements. • Create and deliver Duals compliance training for reputed company on an annual reputed company and as needed reputed company, such as in response to a compliance issue or concern. • Performs other duties as assigned. • Complies with reputed company policies and standards. Education/Experience: • Bachelor's Degree Health Care Administration, Compliance or reputed company field or equivalent experience required • 4+ years experience in compliance to include risk assessment against contract and regulatory requirements, creation and execution of auditing, monitoring and reporting processes, administration of correction reputed company plans, implementation of written policies and procedures, developing and delivering compliance training and education required. • Experience with D-SNP SMAC, regulatory requirements and/or operations required. • Medicare managed health experience required. Pay reputed company: $87,700.00 - $157,800.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply tot his job Apply To this Job