Medical Mutual · 4 months ago
Manager, Medicare Compliance
US-Ohio
Full-time
Hybrid
Senior Level, Lead/Staff
8+ years expMedical Mutual is the oldest and one of the largest health insurance companies based in Ohio, providing high-quality health plans to over 1.2 million members. The Manager, Medicare Compliance is responsible for leading the Medicare Compliance Program, ensuring adherence to regulatory requirements, and managing compliance-related activities.
Health CareHealth InsuranceInsuranceLife Insurance
Responsibilities
Manages the implementation and operation of the Medical Mutual Medicare Compliance Program
Serves as Medical Mutual’s Medicare Compliance Officer
Participates in annual compliance risk assessment and work plan development
Develops and delivers Medicare compliance education, training, and awareness materials
Ensures Medicare policies and procedures are properly created, implemented, and monitored
Conducts and/or oversees Medicare compliance reviews and investigations
Facilitates Medicare Compliance Work Group meetings
Triages Medicare compliance issues and questions received from business areas and ensures provision of accurate and timely responses and recommendations. Escalates compliance issues or concerns as necessary
Oversees Medicare Compliance projects and initiatives
Designs and executes risk management strategies
Prepares and submits compliance reports to regulatory agencies including the Centers for Medicare and Medicaid Services
Plans, coordinates, and/or oversees auditing, monitoring, and due diligence activities
Develops corrective actions and tracks their progress to resolution
Performs other duties as assigned
Qualification
Required
Bachelor's degree required. In lieu of a degree, may consider equivalent combination of education and experience
8 years of experience in health care compliance required
Strong knowledge of Statutory and Federal laws and Regulations that affect our various company products, including Medicare Advantage
Strong understanding of operational, financial, and regulatory controls and risks
Proficiency with PC and MS Office suite; familiarity with LAN / WAN applications
Preferred
Master's degree preferred
At least 5 years of experience in Medicare Advantage preferred
Benefits
Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Company
Medical Mutual
Medical Mutual Provides and administers health benefits for citizens in Ohio.
1001-5000 employees
H1B Sponsorship
Medical Mutual has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (18)
2024 (18)
2023 (17)
2022 (15)
2021 (24)
2020 (16)
Funding
Current Stage
Late StageLeadership Team
Annette Terrien Hill
RNI Chief Operating Officer
Christopher Donovan
Executive Vice President, Chief Data and Information Officer
Recent News
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