Government and Government Relations Attorney in Madison, WI

Profile

Manager-Compliance Duties: Partner with other areas of Dean as appropriate to establish and maintain a high level of compliance. Serve as an expert on compliance matters that affect Dean’s products by identifying compliance requirements and recommending compliant solutions that support business goals. Manage Compliance Specialists and Compliance Solutions Analysts by providing leadership, assistance, training and motivation necessary to mentor and develop staff. Ensure quality of staff work product meets professional standards and promotes best practices. Provide regular compliance reports to the Corporate Compliance Officer, management and the Dean Compliance Committee (DCC). Communicate legal/regulatory changes impacting Dean’s products through support of the Regulatory Change and Communications (RCC) Committee, assist in assignment and identification of tasks necessary to comply with changes. Oversee approval of compliance projects, and ensure compliance projects are prioritized appropriately and completed effectively and timely. Prepare and present management summaries on regulatory compliance topics. Oversee the Compliance Service Request (CR) process. Prioritize, store and prepare reports on the CR process as requested. Oversee the Compliance Incident Management process. Ensure Compliance Incidents are reported, investigated and remediated in an effective and timely manner. Develop and maintain performance metrics and prepare management reports summarizing compliance activities. Serve as a liaison with regulatory agencies, including acting as liaison between internal departments and those agencies. Oversee preparation and review of Annual Compliance training materials, company intranet articles and/or other training and education materials presented by Compliance. Oversee submission of regulatory filings related to existing and new products (including but not limited to commercial policy firms; Medicaid materials, Medicare marketing materials and marketing events, Medicare Cost reports; and contracts with CMS). As Dean’s Civil Rights Coordinator, facilitate investigation into any member allegations of discrimination, maintain documentation of member discrimination complaints filed, and assume primary accountability for Dean’s Civil Rights Compliance Plan. Assist the HIPAA Privacy Officer and the Corporate Compliance Officer in the execution of duties performed in that capacity, including fostering awareness of the importance of the respective programs, safeguarding Protected Health Information (PHI) and supporting the DHP/DHI Corporate Compliance Committee and all sub-committees. Commitment to the highest personal values with the ability to maintain confidentiality.

Qualification and Experience

Qualifications: A bachelor’s degree and a minimum of 5 years relevant work experience. Experience leading projects and/or teams. Familiarity with the managed care environment, Dean Health Plan’s products, the Affordable Care Act, Government Programs and/or the HIPAA Privacy Rule. Strong organizational, planning, analytical and problem solving skills. Able to independently conduct complex and successful research activities and understand and apply regulatory requirements in a corporate setting. Able to draft insurance policy/benefit language and corporate policies and procedures. Detail-oriented, organized, and able to manage multiple priorities to effectively meet production and regulatory deadlines in a fast-paced work environment. Works well both independently and in a high-producing team environment. A motivated, self-starter. Able to work with other departments to foster collaborative relationships that promote corporate compliance. Strong verbal and written communication skills, demonstrated good judgment and ability to express self clearly, concisely and in an organized manner. Strong PC skills in Windows environment (including Word and Excel). Valid driver’s license and personal, reliable vehicle is required for work related travel in order to fulfill position responsibilities. Preferred: MBA or JD Degree. Management or supervisory experience. Experience drafting insurance policies and/or contracts. 2+ years of experience with Medicare managed care compliance (Cost and/or Medicare Advantage), including management of regulatory deadlines, application of Medicare Marketing Guidelines, use of HPMS, interpretation of CMS memos, and interaction with CMS personnel. 2+ years of direct experience with the legislative or administrative law process.

Additional info

Requisition #: 19505129

Company info