Job Details

Plan Compliance Officer

Company name

Organization Type

In-House

Job Type

Attorney

Years of Experience

Min 10 yrs required

Location

Bethesda, MD

Date Last Verified

Aug 14,2017

Posted on

Jul 06,2017
Practice Area
Corporate >> Corporate - General
Health Care >> Health Care
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Plan Compliance Officer The candidate directs and coordinates on behalf of the Medicare Compliance Officer, the Medicare Compliance Program and the Fraud, Waste and Abuse Program for Innovation Healths Medicare Advantage (Part C) and Prescription Drug (Part D) business. Ensure that the requirements of an effective Medicare Compliance program as expressed by CMS in Chapters 9&21 as well as other regulatory guidance are met for Innovation Health and that Firm as a FDR to Innovation Health is meeting these compliance obligations. Work closely with staff at Innovations Health and Firm to ensure that the specific elements of a Medicare Compliance program are achieved and maintained. Distribution and validation of regulatory alerts, oversight and/or performance of auditing and monitoring, evaluating risks and ensuring documentation to demonstrate an effective Medicare Compliance program. Promotes compliance with CMS regulations and related-company policies, including Firms and Innovation Healths Code of Conduct. Reports to the Senior Director of Regulatory Guidance and Compliance Program Effectiveness. This Senior Director is a direct report to Firms Chief Medicare Officer who is the Medicare Compliance Officer for Innovations Health (Joint Venture). Implements and maintains an effective Medicare Compliance program for Innovation Health. Monitors CMS regulations and provides direction to ensure Firms administrative and operational activities as a FDR comply with regulations for Innovation Health. Maintains current working knowledge and expertise in Medicare Compliance with a strong focus on Medicare Compliance Program Effectiveness. Conducts activities, including monitoring and auditing as outlined in Medicare Compliance Work Plan; proposes corrective action where necessary and monitors implementation of such corrective action. Anticipate and respond to future risk situations. Should preferably have Masters or higher degree in Law, Business, Health Care or other applicable area. Must have Bachelor's degree or equivalent experience. Should have 10+ years of work experience with 3-5 years in regulatory/compliance management in Medicare Compliance, experience working on Medicare Compliance program effectiveness (CPE). Strong leadership skills in working cross functionally and in project management in a complex corporate environment is needed. Desktop Tools/Microsoft Outlook skills is required.

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Req: 42452BR

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