OneDigital
Director of Quality Assurance/Compliance
OneDigital, Chicago, Illinois, United States, 60290
Are you looking to accelerate your career without having to hide your authentic self - a place where you can be you? A career that's making a bigger impact on the world? At OneDigital, we are on a mission to help people do their best work and live their best lives. From the services we offer to the way we show up for each other each day, we are fueling dreams, achieving big goals, and embracing each other's truest selves.
We understand that pursuing a new job is a big deal. Maybe you're afraid you won't fit in. Well, here's the good news. For us, the days of "fit in to get in" are over and being different is not a barrier to getting ahead. Greatness comes in all shapes, sizes, colors, and experience levels. If you are looking for a people-first culture that is wired for growth, driven to serve, and totally committed to having your back, give us a shot. Your best life awaits.
Our Newest Opportunity:
Position Summary:
The Director of Quality Assurance/Compliance will oversee the day-to-day operations of the OneDigital Advanced Health QA/Compliance department. This role will work with OneDigital Legal resources to ensure all sales activities comply with regulatory requirements which include guidelines set by the Centers for Medicare and Medicaid Services (CMS) as well as carrier partners. Responsibilities include but are not limited to developing, monitoring, and enforcing compliance policies and procedures related to Medicare Advantage and Prescription Drug Plans (PDP) sales.
Duties and Responsibilities:
Understands and stays up to date on Centers for Medicare & Medicaid Services (CMS) regulations
Works directly with Health Plan Carriers to ensure compliance metrics and standards are held
Serves as point-of-contact for external regulatory and enforcement actions (i.e., data requests, audits, etc.), CMS, and other applicable regulatory agencies.
Improves the efficiency and quality of services through auditing and other methods
Develops, implements, and enforces compliance programs based off CMS standards and regulatory changes
Evaluates compliance training for all levels of staff to support an awareness and understanding of Medicare requirements and promote a culture of compliance accountability.
Prepares reports and presentations required by senior leadership regarding Medicare compliance activities and sales floor activity.
Monitors corrective actions and investigates allegations of improper conduct
Job Requirements:
Bachelor's degree in business, Healthcare, Law, or a related field.
Minimum of 3-5 years of experience in healthcare compliance, particularly in Medicare sales compliance.
Leadership and organizational skills.
Strong knowledge of Medicare Advantage, Medicare Supplement, and PDP regulations
Proficient with Centers for Medicare and Medicaid Services (CMS) guidelines
Proficiency in Microsoft Office Suite
Ability to effectively communicate with all levels of the organization.
Effectively manages multiple projects and deadlines
Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company's performance. We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs. You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts.
To learn more, visit: www.onedigital.com/careers
Thank you for your interest in joining the OneDigital team!
We understand that pursuing a new job is a big deal. Maybe you're afraid you won't fit in. Well, here's the good news. For us, the days of "fit in to get in" are over and being different is not a barrier to getting ahead. Greatness comes in all shapes, sizes, colors, and experience levels. If you are looking for a people-first culture that is wired for growth, driven to serve, and totally committed to having your back, give us a shot. Your best life awaits.
Our Newest Opportunity:
Position Summary:
The Director of Quality Assurance/Compliance will oversee the day-to-day operations of the OneDigital Advanced Health QA/Compliance department. This role will work with OneDigital Legal resources to ensure all sales activities comply with regulatory requirements which include guidelines set by the Centers for Medicare and Medicaid Services (CMS) as well as carrier partners. Responsibilities include but are not limited to developing, monitoring, and enforcing compliance policies and procedures related to Medicare Advantage and Prescription Drug Plans (PDP) sales.
Duties and Responsibilities:
Understands and stays up to date on Centers for Medicare & Medicaid Services (CMS) regulations
Works directly with Health Plan Carriers to ensure compliance metrics and standards are held
Serves as point-of-contact for external regulatory and enforcement actions (i.e., data requests, audits, etc.), CMS, and other applicable regulatory agencies.
Improves the efficiency and quality of services through auditing and other methods
Develops, implements, and enforces compliance programs based off CMS standards and regulatory changes
Evaluates compliance training for all levels of staff to support an awareness and understanding of Medicare requirements and promote a culture of compliance accountability.
Prepares reports and presentations required by senior leadership regarding Medicare compliance activities and sales floor activity.
Monitors corrective actions and investigates allegations of improper conduct
Job Requirements:
Bachelor's degree in business, Healthcare, Law, or a related field.
Minimum of 3-5 years of experience in healthcare compliance, particularly in Medicare sales compliance.
Leadership and organizational skills.
Strong knowledge of Medicare Advantage, Medicare Supplement, and PDP regulations
Proficient with Centers for Medicare and Medicaid Services (CMS) guidelines
Proficiency in Microsoft Office Suite
Ability to effectively communicate with all levels of the organization.
Effectively manages multiple projects and deadlines
Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company's performance. We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs. You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts.
To learn more, visit: www.onedigital.com/careers
Thank you for your interest in joining the OneDigital team!