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Job Requirements of Compliance Practices Oversight Sr. Specialist:
-
Employment Type:
Contractor
-
Location:
Dallas, TX (Onsite)
Do you meet the requirements for this job?
Compliance Practices Oversight Sr. Specialist
Careers Integrated Resources Inc
Dallas, TX (Onsite)
Contractor
Remote position
CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 17 STATES (SC, MS, Client, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside greater-NYC), OH, SC, TX, UT, WA (outside greater-Seattle), WI)
Description:
Will this role be fully remote? yes
Are there any specific locations the candidates should be in - any location
What is the expected schedule (include dates/time/timezone): flexible- preferably 8:30am-5pm.
What are the day to day job duties?
Material compliance review, HPMS submissions.
Top Skills Required:
Detail oriented, focused on closing out tasks, works well with others, knowledge of Medicare
Required Education/Certification(s):
Bachelor or equivalent years experience acceptable
Required Years of Experience: 2
Description
The Sr. Specialist, Compliance Practices Oversight is an integral part of our team, serving as a subject matter expert (SME) for Medicare and Medicaid content regulations and a system and process administrator for the Health Plan Management System (HPMS) supporting operational and marketing content submissions.
Serve as a subject matter expert (SME) in the guidelines and regulations for Medicare and Medicaid operational and marketing content.
Work with Government Contracts, Compliance Department and Legal departments to define required disclaimers and legal statements for Medicare and Medicaid materials.
Act as an administrator for the Health Plan Management System (HPMS) and manage the submission process for defined materials for CMS review according to guidelines and requirements.
Ensure timely communication and responsiveness to issues, tracking to resolution.
Participate in remediation plan development and implementations when problems are identified.
Provide audit support to the Compliance department as needed.
Create policy and procedure documentation and define or improve processes as needed.
Communicate routinely with stakeholders on requirements, including leading and contributing to meetings across internal and external stakeholders.
Create recommendations for stakeholders, compliance and legal teams to consider in response to regulation changes as needed.
Required Experience:
4+ years of experience in compliance, marketing, and compliance programs or audit activities or leading large projects or programs
2+ years of experience interpreting CMS or other government healthcare regulations or Medicaid contracts
Intermediate analytical skills
Strong problem-solving and critical thinking skills
Highly organized and detail oriented with proof-reading and quality control skills
Strong interpersonal, written and verbal communication skills; ability to communicate and facilitate communication with individuals at various levels within the organization and with external vendors
Strong technical skills using Microsoft Applications (i.e., Outlook, Word, Excel, and PowerPoint) and other databases and tools as needed
Previous experience working with the Centers for Medicare and Medicaid Services (CMS) Health Plan Management System (HPMS)
CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 17 STATES (SC, MS, Client, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside greater-NYC), OH, SC, TX, UT, WA (outside greater-Seattle), WI)
Description:
Will this role be fully remote? yes
Are there any specific locations the candidates should be in - any location
What is the expected schedule (include dates/time/timezone): flexible- preferably 8:30am-5pm.
What are the day to day job duties?
Material compliance review, HPMS submissions.
Top Skills Required:
Detail oriented, focused on closing out tasks, works well with others, knowledge of Medicare
Required Education/Certification(s):
Bachelor or equivalent years experience acceptable
Required Years of Experience: 2
Description
The Sr. Specialist, Compliance Practices Oversight is an integral part of our team, serving as a subject matter expert (SME) for Medicare and Medicaid content regulations and a system and process administrator for the Health Plan Management System (HPMS) supporting operational and marketing content submissions.
Serve as a subject matter expert (SME) in the guidelines and regulations for Medicare and Medicaid operational and marketing content.
Work with Government Contracts, Compliance Department and Legal departments to define required disclaimers and legal statements for Medicare and Medicaid materials.
Act as an administrator for the Health Plan Management System (HPMS) and manage the submission process for defined materials for CMS review according to guidelines and requirements.
Ensure timely communication and responsiveness to issues, tracking to resolution.
Participate in remediation plan development and implementations when problems are identified.
Provide audit support to the Compliance department as needed.
Create policy and procedure documentation and define or improve processes as needed.
Communicate routinely with stakeholders on requirements, including leading and contributing to meetings across internal and external stakeholders.
Create recommendations for stakeholders, compliance and legal teams to consider in response to regulation changes as needed.
Required Experience:
4+ years of experience in compliance, marketing, and compliance programs or audit activities or leading large projects or programs
2+ years of experience interpreting CMS or other government healthcare regulations or Medicaid contracts
Intermediate analytical skills
Strong problem-solving and critical thinking skills
Highly organized and detail oriented with proof-reading and quality control skills
Strong interpersonal, written and verbal communication skills; ability to communicate and facilitate communication with individuals at various levels within the organization and with external vendors
Strong technical skills using Microsoft Applications (i.e., Outlook, Word, Excel, and PowerPoint) and other databases and tools as needed
Previous experience working with the Centers for Medicare and Medicaid Services (CMS) Health Plan Management System (HPMS)
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