[Hiring] Enterprise Regulatory Compliance Audit & Monitoring Program Admin I/II/III @company

Role Description

This role performs audits to ensure the organization is in compliance with federal, state and Association regulatory requirements (Centers for Medicare and Medicaid Services, Department of Health, Department of Financial Services, Department of Labor, Blue Cross Blue Shield Association, Federal Employee Plan, Office of Inspector General, Office of Medicaid Inspector General). The Administrator provides collaborative oversight and management of regulatory requirements to achieve optimal compliance performance to meet corporate goals. The incumbent will support risk mitigation by assessing regulatory compliance through various methods including auditing and monitoring, conducting root-cause analysis, identifying best practice opportunities, and making recommendations for process improvement or refinement activities.

Qualifications

• Nine or more years' experience in health insurance or health care delivery, or Bachelor's degree in related area with five or more years of related experience or compliance training.
• Extensive knowledge of regulatory initiatives and legislation that impacts the Health Insurance Industry.
• Demonstrated ability to understand regulations and administer compliance for all areas across an organization.
• Strong analytical and organizational skills and ability to manage multiple projects and systems simultaneously with minimal management directive.
• Demonstrated experience in taking ownership of issues and follow through to resolve them promptly and accurately.
• Exceptional verbal and written communication skills and ability to collaborate across the organization.

Requirements

• Acts as a cross-functional resource to operational areas regarding regulatory compliance matters.
• Performs audits across multiple lines of business.
• May oversee audits performed by external vendors and regulatory agencies.
• Serves as a mentor and shares acquired knowledge and expertise to help others learn and grow.
• Manages the highest level of complex regulatory compliance issues and exercises decision-making in cross-functional work groups.
• Facilitates audits conducted by regulatory agencies.
• Provides guidance to less experienced team members and internal customers in the absence of management.

Benefits

• Compensation Range(s):
• Level II (E4): Minimum: $65,346 - Maximum: $117,622
• Level III (E6): Minimum: $79,068 - Maximum: $142,322
• Participation in group health and/or dental insurance.
• Retirement plan.
• Wellness program.
• Paid time away from work.
• Paid holidays.

Company Description

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.