Senior Compliance Administrator – Corrective Action Plans

Role Overview

• A member of the Compliance Corrections team responsible for the remediation and reporting activities to ensure successful resolution of identified non-compliance with Marketplace and Commercial regulatory requirements, contractual obligations and Company policies and procedures.
• Supports the internal and external corrective action plan lifecycle and related reporting.
• Partners with Product Compliance teams, Shared Services leadership, and market leaders to ensure successful and timely remediation of identified compliance issues.
• Collaborates with compliance and business stakeholders to ensure adequate root cause analysis and development of corrective actions plans to effectively address non-compliance.
• Reviews and oversees progress towards remediation and documented key milestones in GRC tool.
• Identifies issues that require escalation and ensures they are addressed timely through established paths and processes.
• Conducts review of evidence to address root cause of issue and facilitate timely closure of issues.
• Facilitates escalation of barriers identified by other Corrections staff.
• Develops, implements and continually refines corrections reporting that provides meaningful trend analysis for business stakeholders and senior leadership on new, in progress and closed issues as well as regulatory sanctions.
• Supports management in the development and maintenance of corrections processes and tools designed to effectively remediate compliance issues in a timely manner, ensure timely escalation and sustainable resolutions.
• Educates, encourages, and assists those within the company to maintain integrity through correction of identified non-compliance to meet the requirements of Government-sponsored health care programs.
• Performs other duties as assigned.
• Complies with all policies and standards

Requirements

• Bachelor's Degree Healthcare Administration, Compliance or related field required
• 4+ years Compliance and/or regulatory experience in a health care and/or managed care setting/organization required
• Previous experience as a lead in a functional area, managing cross functional teams on large scale projects required
• Excellent Microsoft Office skills and experience with data analytics preferred
• Certified in HealthCare Compliance (CHC) preferred
• Certified Compliance & Ethics Professional (CCEP) preferred

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