Health Care/Attorney/In House/Newark, Delaware
Location: Newark, Delaware
Description: GCC Consulting is currently interviewing Health Care/Attorney/In House/Newark, Delaware right now, this job will be reside in Delaware. Detailed specification about this job opportunity kindly read the description below. Compliance Director Duties: Accountable for successful completion of the annual Medicaid compliance work plan. Monitor Plan performance standards f! or compliance with contractual and regulatory requirements. Operate as the project manager for coordination, collection and distribution of informational material for external and internal reviewers. Serves as the liaison to the Internal Audit Department, Employee Relations and external review groups. Perform marketing monitoring and surveillance in order to ensure compliance with state and federal marketing requirements. Conduct proactive reviews of compliance with high risk processes or issues; initiate and oversee remediation as necessary. Coordinate with Compliance and Regulatory Affairs on investigations of potential non-compliance. Verify control process used to ensure accuracy of information submitted to government agencies. Act as a liaison to the HIPAA and Member Privacy team for investigational support. Ensure regular meetings of the Plan Compliance Committee are held to discuss identification and assessment of compliance initiatives, potential risks and current s! tate. Attend and participate in business strategy meetings wit! h Plan senior leadership. Ensure that contract and regulatory requirements for compliance training, including fraud/waste/abuse training are met. Perform other duties as assigned/requested.
Qualifications : A Bachelor's degree; Masters or higher degree in Law, Business, Health Care preferred. 5+ years of relevant experience in health care compliance or audit with 3+ years of leadership/management experience. The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. Leadership/Driving a Culture of Compliance/MASTERY. Leadership/Collaborating for Results/MASTERY General Business/Demonstrating Business and Industry Acumen/MASTERY. Some travel may be required. Desired: Current license to practice law in at least one state, CPA or CIA. Direct experience working in a relevant federal agency (HHS, OIG, CMS). Compliance, legal or audit experience in a Medicaid/Medicare Managed Care Plan.
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! If you were eligible to this job, please email us your resume, with salary requirements and a resume to GCC Consulting.
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This job will be opened on: Thu, 07 Nov 2013 14:07:07 GMT
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