Medical Mutual · 8 hours ago
Manager, Medicare Compliance
Ohio, United States
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 peace of mind to over 1.2 million members through various health plans. The Manager, Medicare Compliance will oversee the implementation of the Compliance Program, develop training materials, and ensure adherence to regulatory requirements.
Health CareHealth InsuranceInsuranceLife Insurance
Responsibilities
Manages the implementation and operation of the Medical Mutual Compliance Program
Participates in risk assessment and work plan development processes
Develops compliance communications, education and training materials focused on compliance with applicable laws and regulations
Conducts investigations, reviews documents, and develops corrective action plans
Assists in the facilitation of compliance committee meetings, including the review of presentations, risk and issue management, and accountability for action items to remediate risks or issues
Triages compliance issues and questions received from business areas and performs necessary research and analysis to provide accurate and timely responses and recommendations. Escalates compliance issues or concerns as necessary
Oversees projects, initiatives, regulatory audits or exams, and internal compliance reviews; assists with audit readiness
Reviews and analyzes various materials for compliance with regulatory and operational guidelines; revises materials if applicable; coordinates or performs any required approvals and/or submission to regulatory bodies or others if required
Performs other duties as assigned
Qualification
Required
Bachelor's degree required. In lieu of 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
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
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