Sr. Manager, Medicare Compliance - Remote

Why This Role is Important to Us

Position Summary:

The Sr. Manager, Corporate Compliance Ethics manages the day-to-day activities of the corporate compliance ethics program for Commonwealth Care Alliance (CCA). The position manages CCA's Corporate Compliance Ethics programs which include Code of Conduct and corporate ethics administration; corporate investigations; compliance and ethics training, communications, education and awareness initiatives; corporate policy and procedure administration; conflict of interest administration; gifts and entertainment administration; political activities and contributions administration; and regulatory reporting.

Supervision Exercised:

Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.

What You'll Be Doing

Essential Duties Responsibilities:

Manages Conflicts of interest, gifts entertainment, compliance ethics protocols, Code of Conduct, CCA policy procedure processes
Prepare materials and conduct appropriate annual and ongoing corporate compliance training, education, and communication for workforce and board of directors.
Manage and triage compliance concerns and reports received through CCA's confidential hotline.
Conduct thorough, timely and objective compliance related investigations and partner with other areas such as Human Resource and/or Legal.
Respond appropriately to compliance incidents and develop corrective action as needed.
Effective management and oversight of the CCA Corporate Compliance Ethics team.
Identify and drive improvements within the Corporate Compliance Ethics program and processes and proactively identify opportunities for risk controls, education training and/or refined guidelines and protocols.
Oversight of Conflict of Interest (COI) program ensuring appropriate identifying, evaluating, and resolving of potential conflicts of interests.
Manage annual compliance effectiveness survey.
Broad and comprehensive knowledge of OIG compliance guidance on effective compliance programs, a working knowledge of healthcare laws/regulations such as Fraud Abuse, False Claims Act, Stark Law, Anti-Kickback Statute.
Stays abreast of standards and requirements, including all relevant laws, rules and industry standards and company practices.
Performs other duties as assigned
What We're Looking For

Required Education (must have):

Bachelor's degree
Desired Education (nice to have):

Relevant graduate degree (e.g., Juris Doctor or master's degree in a related field)
Required Experience (must have):

5-7 years compliance ethics experience, health insurance preferred
3-5 years of work experience in a managerial/leadership role managing a team directly.
Experience in designing compliance training programs.
Proven ability to effectively and timely manage multiple initiatives and cross- departmental projects.
Required Knowledge, Skills Abilities (must have):

Strong written, verbal, listening and communication skills - having the ability to understand and communicate appropriately to the targeted audience
Strong supervisory/managerial skills.
Manage staff workload appropriately and identify areas of improvement and areas for professional development for staff
Strong analytical skills - having the ability to identify an issue, conduct an analysis to determine business impact (including gapanalyses), troubleshoot

Strategic thinking and planning to continue to enhance the Compliance Program and the role of compliance within the organization: ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions
Strong partnership-, relationship-, consensus- and coalition-building skills required.
Strong emotional intelligence and self-awareness required.
Highly consultative and partnership-oriented in approach.
Strong program and project management skills and experience required.
Strong ability to independently and self-sufficiently identify and navigate various operational issues.
Strong ethical compass and integrity capital required.
Excellent organizational, analytical and problem-solving skills, as well as oral, listening and written communication skills, required.

#J-18808-Ljbffr