What are the responsibilities and job description for the Medicare Operations Compliance Program Manager *Remote position at Providence?
Description
Providence Health Plan is calling a Medicare Operations Compliance Program Manager who will:
Ensure compliance with regulatory requirements and standards specific to Medicare Advantage are met plan-wide
Ensure that Medicare Advantage regulatory requirements and standards are understood by the operational/business areas
Implement business processes and controls to ensure compliance
Research business area compliance issues and recommend changes that assure compliance with CMS contractual requirements
Maintain a positive relationship with business owners
Influence decisions
We welcome 100% remote work for residents who live in the States of Oregon and Washington.
Required qualifications for this position include:
Bachelor's Degree in Business Administration, Economics, Healthcare Administration, or another related field of study -OR- a combination of equivalent education and 5 years of work experience
4 years demonstrated successful and progressive positions
3 years management (or relevant) experience
Management experience in managed care environment specific to a health plan
4 years demonstrated successful experience working with administrative, policy and/or operational aspects of the Medicare program, preferably in a managed care environment
2 years experience with Medicare Advantage health plan regulatory compliance matters
Preferred qualifications for this position include:
5 years' work experience
4 years management (or relevant) experience
5 years demonstrated successful experience working with administrative, policy and/or operational aspects of the Medicare program, preferably in a managed care environment
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.
We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.
We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.
Requsition ID: 213087
Company: Providence Jobs
Job Category: Member Services Enrollment & Billing
Job Function: Health Plans Services
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 COMPLI GOVERNMENTAL AFFAIRS OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Pay Range: $40.90 - $66.02
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page n about our Benefits and Rewards.
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Salary : $41 - $66
