Director, HEDIS Compliance
October 28
Description
• Conduct compliance audits • Write corrective action plans • Work with contract and department managers to ensure compliance with local, state and regulatory requirements • Represent the key leadership position for compliance at the health plan • Oversee communication, coordinate policy development • Investigate instances of suspected fraud • Assist management with enforcement and discipline in instances of non-compliance • Inform health plan’s Board of Directors of compliance status and activities • Oversee the Compliance department
Requirements
• Bachelor’s degree in related field or equivalent experience • 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits • 2+ years experience in the development of compliance and fraud programs • 2 years experience with overseeing implementation of contract requirements • Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff • At least 25% travel will be involved
Benefits
• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules
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