Compliance Manager - Investigations - Health Alliance Plan

Health Alliance Plan of Michigan in Troy, MI

  • Industry: Advertising/Marketing/Public Relations - Marketing Director
  • Type: Full Time
  • Compensation: $132,180.00 - 205,690.00 / Year*
position filled

Plan, lead and manage the day-to-day operation of the Compliance Program, regulatory audit, FDR oversight, and risk assessment for all HAP and HAP subsidiary lines of business. Responsible, under the direction of the Director-Compliance, to provide overall strategic direction to manage compliance. Develop and implement compliance processes, compliance risk assessments and assist in the development of compliance education. Act as a liaison for the Compliance department, collaborating with key departments and Compliance Leads to ensure policies and procedures are designed, developed, and implemented to ensure compliance and collaborate with cross-functional teams to develop, enhance and implement departmental compliance programs to promote continued awareness and adherence to compliance. Manage audit activities related to compliance issues and violations including coordinating with business units and departments to monitor and assess violations, ensure timely investigations and corrective actions as well as tracking of violations for the purpose of annual reporting.

  • Develop and implement annual compliance work plans, risk assessments and other compliance program materials that reflect and address mitigation requirements for compliance program risks. Assist in development of policies and procedures in accordance with compliance rules and regulations.
  • Disseminate written policies and procedures related to compliance activities.
  • Manage regulatory audit program to ensure compliance procedures are followed.
  • Lead, plan, develop and conduct education and training activities related to compliance activities and topics.
  • Develop presentations and educational materials for departments and individuals at all levels to provide education and compliance regulatory updates.
  • Represent Director-Compliance when necessary to facilitate compliance committees.
  • Implement monitoring and reporting process regarding all ongoing compliance activities under the direction of the Director-Compliance.
  • Oversee the analysis and investigation of compliance violations.
  • Conduct routine audits of the compliance program.
  • Perform other duties as assigned.
  • Bachelor s degree in health care
    administration, public health, business, or related field. Master's preferred.
  • Minimum
    of five (5) years experience in insurance industry which includes:
    • Experience in healthcare compliance
    • Experience with Affordable Care Act, Medicare Advantage, Part D,
      and Medicaid compliance regulations
    • Working knowledge of corporate compliance policies/procedures
  • Two (2) years
    experience in a managerial/supervisory position and with leading staff in
    projects within a health care environment preferred.
  • Certification
    or designation in health care or managed care a plus

* Estimated salary

More Jobs Hiring Near Me!

Quality Specialist, Product Release (Midnight Shift)
Par Pharmaceutical

The Quality Specialist, Product Release reviews all pertinent records, including Batch Production Records and laboratory Certificates of Analysis to …

Read More
External Wholesaler
Flexible Plan Investments

External Wholesaler Company Name Flexible Plan Investments, Ltd. Company Location Bloomfield Hills, Michigan Flexible Plan Investments is an innovati…

Read More
Technical Publications Project Manager
BAE Systems - Platforms & Services Sector

Job Description BAE Systems, one of the world's largest defense contractors and a stable Fortune 500 company, has multiple openings for a Technical M…

Read More
Product Manager
TE Connectivity

At TE, you will unleash your potential working with people from diverse backgrounds and industries to create a safer, sustainable and more connected …

Read More
PRODUCTION MANAGER III at Ascension Macomb-Oakland Hospital-
Compass Group

TEXT TO APPLY: You can now complete your entire job application for this job via SMS text messaging!Simply text JOB to 75000 & search for the requisi…

Read More
Associate General Counsel (Canton)

Job Function Summary: The incumbent is responsible for advising Getinge business leaders on risks under US healthcare fraud and abuse laws and regula…

Read More
Quicken Loans: Search engine optimization marketing manager
Quicken Loans

The Search Engine Optimization (SEO) Marketing Manager generates web traffic for Quicken Loans. This team member drives their own programs, in additi…

Read More
Digital Product Manager
Quicken Loans

Minimum Qualifications Bachelor s degree in business, computer science or a related field 2 years of product management experience Passion for digita…

Read More
Senior Digital Product Manager
Quicken Loans

Minimum Qualifications Bachelor s degree in business, computer science or a related field 5 years of product management experience Passion for digita…

Read More
Product Manager
Quicken Loans

The Rock Family of Companies is made up of nearly 100 separate businesses spanning fintech, sports, entertainment, real estate, startups and more. We…

Read More