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Job: Senior Compliance Manager

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Jobing Description

Under the direction of the Chief Compliance Officer, the Senior Manager, Compliance shall administer the compliance program for Health Choice Preferred Network of Arizona, IASIS Healthcare’s accountable care organization (ACO) and Bundled Payment Care Initiative (BPCI).  This individual will also support compliance related activities associated with the Health Choice Medicaid and Medicare Advantage products.
This position reports directly to the Chief Compliance Officer and is primarily responsible for managing compliance program activities for the ACO and BPCI in coordination with leadership and designated staff.  This position shall serve as the ACO and BPCI Compliance Officer and is responsible for staging quarterly compliance committee meeting for these entities.
This individual shall also conduct auditing and monitoring activities and support the annual review and revision of the ACO and BPCI compliance program materials, including the compliance program plan, risk assessment and audit work plan as well compliance related training and education.
This position shall also help review and confirm impact of address new and changes to existing legal, regulatory and contractual requirements (the Requirements) that apply to the ACO and BPCI.
This position shall perform other compliance program activities, as assigned, that apply to all lines of business.
Candidates must possess critical thinking skills, demonstrated written and verbal communication ability and strong project management experience within a matrixed environment.

Job Responsibility:
1.Administer the ACO and BPCI compliance program (25%);
2.Conduct ACO and BPCI auditing and monitoring activities (20%)
3.Review and confirm the impact of new and changes to existing legal, regulatory and contractual requirements (the Requirements) that apply to the ACO and BPCI. Establish action plans in response to changes to the Requirements and monitor timely closure of items on those plans (10%); and
4.Perform other compliance program activities, as assigned, that apply to all lines of business (35%).

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled


Professional Competencies (knowledge, skills, and abilities):

* General knowledge of ACOs, BPCI preferred.
* General knowledge of Medicaid and Medicare Advantage product operations
* General knowledge of state and federal health care laws
* Knowledge of government payer contracts

* Demonstrated analytical, organizational and problem solving skills.
* Strong written and verbal communication skills.
* Computer skills (Especially MS Word, Excel and PowerPoint)
* Grammar and editing abilities
* Attention to detail and curiosity to learn required
* Presentation skills required

* Work cooperatively, positively, and collaboratively in an interdisciplinary team
* Ability to work independently
* Ability to work well and communicate with all levels of staff/management and external stakeholders, including regulators and payor partners
* Ability to manage multiple projects and prioritize work tasks to adhere to deadlines and identified time frames
* Proven ability to think strategically and to translate strategic directives into tactical initiatives.
* Proven ability to drive cross-functional teams to deliver operational compliance.
* Adept at understanding complex concepts and situations presented by the business environment.
* Ability to assess complex problems and provide the appropriate compliance solutions.
* Ability to adapt in a dynamic and matrixed environment.
Education: Bachelor's degree required. 

* 1or more years of experience working in a regulatory and/or compliance role
* 1or more years of experience with Medicaid and Medicare Advantage products
* 1or more years of experience with and knowledge of auditing and monitoring.
* Experience in a strategic role supporting implementation of a comprehensive compliance program.
* Experience managing multiple projects/tasks. Proven history of successful results in managing issues and driving strategic program initiatives.
* Experience working as a Subject Matter Expert in a matrixed organization, working with various departmental leads and/or stakeholders.

Certification and License: None

Skills / Requirements

Important Notes