Manager-Compliance Office (Remote)

Regulatory & ComplianceRemote, United States


Description

American Specialty Health Incorporated is seeking a Manager-Compliance Office to join our Regulatory and Strategic Development (RSD) department. This position will ensure effectiveness of the Compliance Program and Plan with related compliance activities being completed within the timelines specified by law, regulation, contractual requirement and/or management as well as the furtherance of the company’s enterprise risk management efforts. This includes keeping Associate Director, Compliance Office and other senior management apprised of issues and concerns, including regulatory and audit developments impacting the Compliance Program and Plan. 

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Salary Range

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $62,400 to $70,000 Full Time Annual Salary Range.

 

Responsibilities

  • Leads the completion of Compliance Program and Plan activities as directed by the Associate Director, Compliance Office. Examples include:
  • Managing the Compliance Office’s response to client compliance program audits and attestations.
  • Assists with the development of compliance trainings.
  • Managing the company’s annual risk assessment and work plan as directed.
  • Reviews prospective vendors to determine if they would be classified as a downstream entity per CMS requirements and provides guidance to internal stakeholders regarding the same.
  • Research compliance program requirements to ensure compliance and makes recommendations to the company’s Compliance Program and Plan.
  • Provides information and direction with regard to Compliance Program and Plan requirements to internal departments and assists with resolution of issues.
  • Assists Associate Director, Compliance Office with completion of Board Reports and preparation of documentation and other reports at the request of the Associate Director, Compliance Office, or senior management.
  • Keeps Associate Director, Compliance Office and senior management informed of all issues, including industry and audit developments, for assigned responsibilities.
  • Assists the Associate Director, Compliance Office with tracking topics and issues for updates to the Code and completing annual review process of the document.
  • Manages and coordinates annual review and update process for all Compliance Office policies and procedures. Assists management from internal departments with the development of policy and procedures demonstrating compliance with the Compliance Program and Plan. Acts as liaison between internal departments and, in conjunction with the Regulatory Compliance department, external regulatory agencies to ensure compliance with Compliance Program and Plan requirements across all ASH entities. This includes consulting on related inquires, filings and contracts as well as developing tools to help ensure compliance, training, and client audit/market conduct preparedness.
  • Participates on company committees or attend related meetings, including CCCs and KPTs, as directed by the Associate Director, Compliance Office.
  • Serves as the primary back-up for the Associate Director, Compliance Office with respect to Compliance Office functions and keeps the Associate Director, Compliance Office and senior management informed of all issues impacting the company’s Compliance Program and Plan.
  • Sets up and maintains electronic/paper files.
  • Provides support as directed by Associate Director, Compliance Office for ad hoc projects involving the department.
  • Completes all ASH University training requirements, including required regulatory trainings, as well as ad hoc trainings required by management, within required timeframes.
  • Obtains or maintains, as directed by the Associate Director, Compliance Office, other senior management and budget resources, nationally recognized professional designations.

Qualifications

  • Bachelor’s degree in English, History, Political Science, or equivalent field preferred; Master’s in Health Care Administration and/or Legal degree, paralegal or legal secretary certificate or equivalent experience with a high school diploma required.
  • Minimum 5 years of experience with regulatory compliance in a health care environment, with a strong understanding of state and federal regulatory agency laws/regulations pertaining to Compliance Program functions for health insurance, wellness programs, and managed care. Experience with Medicare compliance requirements preferred. 
  • Experience with managed care operations and wellness program business supporting Utilization Review, Third Party Administrator, Network Management, and specialized health care services particularly desired.
  • Experience with evaluation of compliance programs and processes, including risk assessments, audits and implementation of new laws, regulations and compliance guidelines required.
  • Proficient in MS Word, Excel, and SharePoint
  • Strong organizational, audit and project management skills to advance effectiveness of the corporate Compliance Program and Plan.

Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.
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