Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments
Audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness
Establish project plans, gap analysis, milestone dates, and other significant aspects, and leadership updates
Maintain knowledge of laws, regulations, company strategies to assess impact, and consult with clients as subject matter expert
Conduct complex investigations, document findings, and ensure corrective actions are made
Interface with external clients, regulators, vendors, suppliers; internal stakeholders, high level of management

Requires a BA/BS
Minimum of 6 years health care, regulatory, ethics, compliance or privacy experience
MS/MBA/JD or professional designation preferred
Six Sigma certification preferred
Regulatory compliance experience strongly preferred
Medicare, Medicaid, and/or Commercial experience strongly preferred
Regulatory analysis experience strongly preferred
Utilization management (UM) knowledge and experience strongly preferred
Health insurance industry experience preferred
Risk assessment and audit experience preferred
Client engagement experience preferred
Strong written and oral communication skills
Experience presenting to senior leaders up through C-Suite preferred.

Compliance Manager

Key skills