Compliance Lead

    • Flexible / Remote

Description

The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Compliance Lead develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. May be over privacy staff also. Responsible for hiring, training, and firing staff. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Required Qualifications

  • Bachelor's Degree
  • 8 or more years of technical experience
  • 2 or more years of project leadership experience
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Advanced experience with building, collecting, validating, and communicating large sets of data
  • Experience working with Clinical Providers Offices
  • Experience in Revenue Cycle reviews
  • Experience inRisk Adjustment andFalse Claimdocumentation and coding auditing


Preferred Qualifications

  • CRC an/or CPC certified
  • Project Management Professional (PMP) certification
  • Six Sigma certification
  • Experience in an audit or compliance role
  • Leadership experience


Additional Information

Scheduled Weekly Hours

40


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