Medicare Compliance Officer

Description

SHR Talent is representing a client in its search for a full-time Medicare Compliance Officer. The individual in this role is preferred to be onsite.

Essential Job Functions

• Develop strategies to promote and encourage a culture of compliance;
• Ensure coordination of compliance program with business strategies and practices;
• Report on external regulatory audit status and corrective action plans
• Ensure company has appropriate, up-to-date Compliance policies and procedures
• Ensure risk assessment is conducted annually
• Ensure development and implementation of a risk-based auditing and monitoring program
• Lead and facilitate Medicare Compliance Committee meetings;
• Provide reports to the Audit Committee on any relevant compliance issues quarterly;
• Works with the business to ensure compliance with governmental regulations, laws and policies;
• Implements and leads auditing and monitoring activities of the Medicare Compliance Program,
• Perform ongoing compliance audits
• Develops, recommends, implements, and monitors areas of non-compliance with corrective action plans.
• Builds and develops relationships internally and externally with vendors to help drive strategic objectives with the business;
• Assists with state and federal regulatory filings;
• Serves as liaison between Compliance and business/subject matter expert units related to all compliance audits and business processes; Communicates with regulators and executive leaders;
• Perform review of annual companywide and new employee compliance training program.

Qualifications

• Bachelor’s degree or equivalent work experience required.
• Direct experience in a role directly managing key aspects of a compliance program required.
• Direct experience working in a government, legal, healthcare, managed care and/or health insurance environment in a regulatory, privacy or compliance role.
• Direct Healthcare industry or Healthcare related industry experience preferred.
• Experience managing teams, major program initiatives or working with regulatory agencies required.
• Professional certification (Certified in Healthcare Compliance – CHC or similar) is a plus

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