Download App | FOLLOW US ON SOCIAL MEDIA
 Upload Your Resume   Employers / Post Jobs 

Health Care Attorney in Detroit, MI

Blue Cross Blue Shield of Michigan Feb 17,2016 Dec 09,2015 Location USA Detroit MI
This job is expired...

Public Interest

Attorney

Health Care

Litigation - Whistleblower - CFTC

4-7 yrs required

Profile

Senior Medicare Compliance Analyst Duties: Will have Leadership responsibility to coordinate the development and implementation of programs and strategies to improve service to customers. Will work within the medicare compliance department. Will be primarily responsible for conducting Part C and Part D monitoring reviews/audits, reviewing and interpreting CMS regulations, engaging in Medicare projects and business improvement initiatives, and other assigned tasks. Will also engage business departments to assist with daily compliance needs, including building and refining processes, reviewing policies and procedures, building collaborative relationships, and representing the Medicare Compliance Department in a professional manner. This position will work closely with Medicare Operations, Medicare Program Oversight and Legal. Develop and improve work flows and business processes within area(s) to improve customer service, decrease operational costs and improve overall quality. Identify and/or analyze business problems and devise procedures for solutions to the problems. Effectively lead projects/teams in order to produce desired results. Responsible for corporate communication of project results. Recommend and assist with implementing standard policies and procedures for providing routine service. Assure that corporate compliance is communicated, implemented and monitored on an ongoing basis. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Assist personnel (both internal and external) by answering questions, supplying information and training. Develop and maintain an effective working relationship with customers. Perform other duties may be assigned.

Qualification and Experience

Qualification Requirements: A Bachelor's degree in related field required. Juris Doctor, Nursing Degree, Masters in Health Care Administration, Master's degree Business Administration in Accounting or Finance preferred. 4-7 years of experience in related field. Supervisory and/or Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities. Project management experience. Process improvement experience. Experience with SharePoint. Knowledge of Medicare Part C & D regulations. Knowledge of elements of an effective compliance program. Experience in creating policies and procedures from regulatory guidance. Experience in regulatory analysis and interpretation. Knowledge of pharmacy and PBM industry. Knowledge of Medicare Part A & B regulations. Proficiency in Microsoft Word, Access, Excel, and PowerPoint. Strong healthcare and business knowledge,. Strong research and analytic skills. Strong interpersonal skills. Ability to work independently with minimal supervision in a fast pace environment. Ability to analyze issues and data and form appropriate. solutions/conclusions. Goal and results oriented as well as the ability to multi-task. Willingness to take on new challenges. Ability to plan, organize, direct and control projects. Ability to lead and contribute to process improvement projects. Working knowledge of PC applications and/or mainframe required. Excellent other related skills and/or abilities may be required to perform this job.

Additional info

Ref. # GEN0007C.

Company info