Compliance Manager jobs in United States
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Amida Care · 8 hours ago

Compliance Manager

Amida Care is the largest Medicaid HIV Special Needs Plan in NY, delivering an innovative care model focused on member health outcomes. The Compliance Manager will work collaboratively to ensure compliance with Medicaid regulatory requirements and internal policies, overseeing various compliance-related tasks and audits.

Child CareHealth CarePharmaceutical
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Diversity & Inclusion

Responsibilities

Reviews the Monitoring Report and follow up for evidence of Monitoring with appropriate Business Units
Responsible for oversight of required regulatory reports and follow up for evidence
Assists with scrubbing and analyzing OMIG audit data and preparing initial draft response
Assists with Provider Investigative Report data gathering and input in HCS system
Assists with FWA tasks and other functions as needed
Responsible for tracking distributed Regulatory Requirements and responsible for getting status updates from appropriate business units
Assists with the preparation of materials for Article 44/49 full operational and targeted surveys
Assists with research regarding current or pending regulatory requirements as needed
Assists Sr. Director Compliance/Compliance Officer with Mental Health Parity meeting preparation and follows up on regulatory requirement/items
Tracks and monitors required follow-up with Vendor Management staff regarding identified vendor compliance issues
Assists with obtaining information for education and training materials
Provides assistance with regulatory inquiries from business areas
Assists with internal audits as needed
Assists with report preparation for Compliance Committee meetings and BOD meetings
Assists with PolicyStat tasks
Performs other duties as assigned

Qualification

Healthcare ComplianceMedicaid Managed CareMS Office SuiteRegulatory ResearchCultural SensitivityInterpersonal SkillsVerbal Communication

Required

Bachelor's Degree or equivalent combination of education and relevant work experience
Five (5) years' experience in the field of Healthcare Compliance
General knowledge of Medicaid Managed Care
Efficient with MS Word, Excel, PowerPoint, Office
Exhibits ability to work independently with diligence
Exhibits a strong commitment to the integrity and effectiveness of the Compliance Department
Demonstrates ability to work collaboratively and effectively with all areas of the Company
Demonstrates interpersonal and verbal communication skills
Demonstrates ability to research facts regarding Compliance issues and incidents
Demonstrates understanding and sensitivity to multi-cultural values, beliefs and attitudes of both internal and external contacts
Demonstrates appropriate behavior in line with the Company's mission, vision and values

Company

Amida Care

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Amida Care is an organization providing healthcare, meals, advocacy, research and social services.

Funding

Current Stage
Growth Stage

Leadership Team

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Doug Wirth
President/CEO
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Alex Fontanez
Associate Director of Partnerships & Ombudsman
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Company data provided by crunchbase