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Independent Living Systems, LLC · 2 months ago

Vice President, Health Plan Compliance

Miami, FL, US

Full-time

Onsite

Director/Executive

10+ years exp

Independent Living Systems (ILS) is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. The Vice President of Health Plan Compliance plays a critical leadership role in ensuring adherence to regulations governing health plan operations and is responsible for developing and maintaining compliance programs across the organization.

Health Care

Responsibilities

Develop, implement, and oversee the health plan’s compliance program to ensure adherence to all relevant laws, regulations, and accreditation standards

Monitor regulatory developments and assess their impact on organizational policies and procedures, providing timely guidance to leadership and staff

Collaborate with cross-functional teams including legal, operations, and quality assurance to integrate compliance requirements into business processes

Stay up-to-date on changes to laws, regulations, and policies related to health plan compliance, and ensure that the organization is in compliance with these changes

Lead and manage a team of compliance professionals

Qualification

Health plan complianceRegulatory affairsFederalState regulationsRisk management principlesCompliance program managementMedicareMedicaid experienceAnalytical skillsTraining initiativesAudit managementLeadership skillsTeam managementCommunication skillsCollaboration skills

Required

Bachelor's degree in Health Administration, Business, Law, or a related field

At least 10 years of experience in health plan compliance or regulatory affairs within the health care services industry

Demonstrated knowledge of federal and state health care regulations including HIPAA, CMS guidelines, and the Affordable Care Act

Proven experience leading compliance programs and managing teams

Strong understanding of health plan operations and risk management principles

Relevant experience may substitute for the educational requirement on a year-for-year basis

Preferred

Master's degree in Health Administration, Public Health, Law, or a related discipline

Certification in health care compliance such as Certified in Healthcare Compliance (CHC) or equivalent

Experience working with Medicare and Medicaid health plans

Proven track record of successfully managing regulatory audits and investigations

Company

Independent Living Systems, LLC

Independent Living Systems, LLC, offers a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid and Dual-Eligible Market.

Founded in 2001

Miami, Florida, USA

501-1000 employees