Director, Medicare Compliance

Company: SCAN Health Plan
Location: Long Beach
Posted on: November 17, 2022

Job Description:

Director, Medicare ComplianceLong Beach, -CA (Remote)Full-timeAbout SCANSCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit , , or follow us on LinkedIn, Facebook, and Twitter.The OpportunityDirect plan initiatives and lead processes to achieve and maintain compliance with federal regulatory requirements and contract standards. Lead a team responsible for implementing regulatory and contract requirements, and serve as the plan's lead contact with CMS on contract and regulatory compliance issues.You WillLead the plan's regulatory compliance efforts with the Centers for Medicare & Medicaid Services (CMS). -Establish and maintain positive working relationships with CMS by effectively communicating organization position, including efforts in the market place, and responding to requests.Responsible for providing timely analyses and interpretations of new and existing federal requirements. -Direct the work of Compliance staff who serve as Compliance Liaisons as they provide subject matter expertise and support to their assigned plan departments on complying with federal regulatory and contractual requirements.Establish and cultivate positive, effective relationships with regulators.Oversee the plan's process for tracking new regulatory, and identifying the implications for the plan so that clear guidance is provided to accountable departments in terms of what actions need to be taken to achieve compliance.Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.Establish, manage, and report own department's performance by use of metrics and key measurements.Manage assigned Compliance department duties and achieve performance goals while staying within budget, unless otherwise agreed upon by the Compliance Officer.Maintain confidence and protect operational activities by keeping information confidential.Represent the department on committees as assigned by the Compliance Officer.Present regularly on Compliance issues to the Enterprise Compliance Committee and Compliance Policy Committee (as assigned).Other duties as assigned.RequirementsYour QualificationsBachelor's Degree, or equivalent career experience is required.8+ years of -experience in compliance, required.8+ years leadership/management experience.5+ years experience in managed health care, required.3+ years' experience managing resources of a business unit, including financial budgets.3+ years' experience developing and maintaining business planning strategies.Proven ability to exercise independent thought and decision-making skills.Ability to work effectively and participate in a team environment.Ability to challenge regulators, peers and superiors when necessary while maintaining respect and professionalism.Demonstrated detail-oriented quality work product.Proven ability to interact effectively with staff from all levels of the plan.Ability to work independently, prioritize and manage multiple tasks effectively and function in a complex, fast paced environment.Strong interpersonal skills, including excellent written and verbal communication skills.Strong organizational skills; Ability to multitask.Ability to appropriately maintain confidentiality.Strong analytical and critical thinking skills, required.Covid-19 Vaccination PolicyTo ensure a healthy and safe work environment, all SCAN employees will be required to be fully vaccinated by January 1, 2022. Generally, you are considered fully vaccinated 14 days after receiving the last dose, as recommended by the manufacturer, of a vaccine that has been authorized by the FDA for use in the United States, including vaccinations that have been approved pursuant to an Emergency Use Authorization. If fully vaccinated outside of the United States, the vaccination must be listed for emergency use by the World Health Organization (WHO). - -If you cannot receive the vaccine because of a disability/medical reason or sincerely-held religious belief, you may request an accommodation to this requirement by contacting -COVID-19@scanhealthplan.com. Learn more about the COVID-19 vaccination here - -.What's in it for you?A competitive compensation and benefits program -An annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)11 paid holidays per year, plus 1 additional floating holidayExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementA work-life balanceAn opportunity to become part of a team that makes a difference to our members and our community every dayWe're always looking for talented people to join our team! - Qualified applicants are encouraged to apply now!At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.#LI-CS1Job SummaryRequisition Number: DIREC004357Job Category: ComplianceSchedule: Full-Time

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