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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Attorney
Health Care
Litigation - Whistleblower - CFTC
Min 3 yrs required
Health Plan Compliance Consultant Responsibilities: Develop and manage site Compliance Committee meetings. Ensure written standards and procedures. Provide training, communications and education. Ensure proper reporting and response to state stakeholders. Conduct auditing and monitoring, to ensure compliance. Oversee contract compliance activities and vendor oversight. Remain vigilant regarding fraud, waste and abuse. Ensure privacy within the healthplan. Ensures that procedures are in place to review and report possible violations in accordance with the reporting requirements as outlined in the FWA Plan. Reviews vendors to make sure that all aspects of FWA are managed and policies are developed where gaps are identified.
Qualification and Experience
Qualifications: Bachelor's degree or equivalent experience. 3+ years of experience in a FWA, regulatory or compliance role. 3+ years of experience working in a government, healthcare, managed care or health insurance environment. Experience developing and presenting training programs. Experience leading audits and major program initiatives. Experience developing relationships with regulatory agencies. Ability to identify root cause issues and ensure appropriate corrective action. Intermediate or better proficiency using MS Word, MS Excel and MS PowerPoint. Master's degree or JD. 3+ years of experience and knowledge working with Kansas Medicaid. 3+ years of experience and knowledge working with state level regulators.
Ref. 564374
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