Medica
Compliance Program Consultant II
Medica, Minnetonka, Minnesota, United States, 55345
The Compliance Program Consultant II supports Medica's Vendor Oversight Compliance Program. This position requires you to have a keen attention to detail, a strong understanding of compliance program effectiveness as well as an interdisciplinary understanding of health plan operations. This position works as a liaison across Medica to review and document whether a vendor is considered an FDR, delegate, or a DHS subcontractor. Leads and coordinates annual delegate audits, investigates incidents, and monitors corrective action plans to ensure compliance with state and federal regulations to detect and correct non-compliance.
Key AccountabilitiesConducts annual delegation audits of assigned delegatesReviews vendor contracts to determine if a vendor is an FDR, delegate, or a DHS subcontractor. Liaison between Compliance, Enterprise Sourcing Team (EST), and business ownersCreates corrective action plans related to assigned delegatesInvestigates incidents related to assigned delegatesAssists with other internal and external audits related to delegates (e.g. SOC or CMS Program audit), and other department projects as assigned
QualificationsBachelor's degree or equivalent experience in related field3+ years of related work experience beyond degreeUnderstanding of compliance programs and business functions requiredUnderstanding of federal and state regulations, laws and obligations relating to Medicare, Medicaid, and Qualified Health Plans
Skills and AbilitiesExcellent analytical / problem solving abilityAbility to operate independently and handle multiple, complex projects with a high degree of initiativeProven ability to communicate effectively with all levels of an organizationAbility to organize complex information and to effectively report information to leadershipExcellent writing skillsHigh standard of ethics, responsibility, discipline, and professionalism
This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.
The full salary range for this position is $67,100 - $115,100. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
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Key AccountabilitiesConducts annual delegation audits of assigned delegatesReviews vendor contracts to determine if a vendor is an FDR, delegate, or a DHS subcontractor. Liaison between Compliance, Enterprise Sourcing Team (EST), and business ownersCreates corrective action plans related to assigned delegatesInvestigates incidents related to assigned delegatesAssists with other internal and external audits related to delegates (e.g. SOC or CMS Program audit), and other department projects as assigned
QualificationsBachelor's degree or equivalent experience in related field3+ years of related work experience beyond degreeUnderstanding of compliance programs and business functions requiredUnderstanding of federal and state regulations, laws and obligations relating to Medicare, Medicaid, and Qualified Health Plans
Skills and AbilitiesExcellent analytical / problem solving abilityAbility to operate independently and handle multiple, complex projects with a high degree of initiativeProven ability to communicate effectively with all levels of an organizationAbility to organize complex information and to effectively report information to leadershipExcellent writing skillsHigh standard of ethics, responsibility, discipline, and professionalism
This position is a Remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.
The full salary range for this position is $67,100 - $115,100. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
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