Job Details:

This position is responsible for coordinating the oversight of compliance programs of all Medicare First Tier, Downstream and Related Entities (FDRs) and identified vendors to ensure compliance with all state and federal regulations and have effective compliance programs to prevent, detect and re-mediate noncompliance. This position also assume responsibility for reviewing RFP responses for regulatory compliance, including General Compliance, Auditing, Monitoring and HIPAA.

Qualifications:

• Bachelor’s degree or equivalent work experience is required.
• Knowledge of the Federal and State regulatory environment in the health insurance industry.
• Experience with communicating the organization’s position to external entities

Culture:

We're a rapidly growing nonprofit organization providing integrated health care and social support services to people with complex medical needs. Our patients are seniors and persons with disabilities covered under Medicaid or both Medicaid and Medicare. Our innovative care model is nationally recognized for its effectiveness in improving health outcomes for these vulnerable populations.