Job Details

Senior Manager, Ethics & Compliance

Company name

Organization Type


Job Type


Years of Experience

Min 5 yrs required


Woodland Hills, CA

Date Last Verified

Oct 17,2017

Posted on

Jul 30,2017
Practice Area
Government and Government Relations >> Government and Government Relations
Apply for this job
Your Email:
Upload Resume:

113 hits


Senior Manager, Ethics & Compliance Duties: Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company. Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities. Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures. Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations. Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Conduct compliance audits, develop and implement corrective action plans. Perform plan risk assessments and report emerging trends, deficiencies and variances; report findings to other departments and teams as appropriate. Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees. Provide mentoring and guidance to subordinates within the department as necessary. Serve as primary backup to department lead as necessary. Commercial Insurance (additional responsibilities): Monitor Commercial product risks in accordance with the risk reporting policies. Manage Benefit Filings and entity licensures for all products to ensure compliance with state and federal regulatory requirements. Work in collaboration with Marketing teams to monitor Sales & Marketing representatives and materials used in advertisements. Medicare (additional responsibilities): Monitor the FDR oversight program to ensure all Medicare and MMP plans are conducting the appropriate oversight in a timely manner. Report all Medicare and Medicaid product risks in accordance with the risk reporting policies. Partner with various departments as the local executive responsible for ensuring that state and/or federal regulatory requirements relating to business continuity and disaster recovery are communicated and met.

Qualification and Experience

Qualifications: Bachelors’ degree in related field or equivalent experience. Master's or JD Degree preferred. 5+ years of compliance experience, preferably in a healthcare environment with at least 3+ years of Medicaid, Medicare or Commercial Managed Care experience. Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment preferred.

Additional info

Ref - 1060743

Company info

Apply Now

Similar Jobs:

Senior Wealth Manager Fiduciary Specialist Duties: Serves as the trusted advisor to high net worth clients and their families, as well as charitable trusts and foundations. Managing and administering client relationships primaril...
Tax Senior Manager - Private Client Services Duties: Oversee the efforts of multiple teams on client engagements; plan, execute, direct, and complete tax projects in a wide variety of industries; provide innovative tax planning, ...
Tax Services Senior - National Tax - Business Tax Services - Partnership Transactional Planning & Economics Group Duties: Working in small groups on projects with internal or external clients. collaborate with national subject ma...