Description:e-TeleQuote --- Where Your Passion Meets Purpose We are looking for a Compliance Manager to be part of a company that is continuing to grow and make a difference in the Medicare industry.
In this role, you will primarily be responsible for assisting in the development, implementation, and oversight of operations compliance across the organization
Responsibilities of the Medicare Compliance Manager: Responds to carrier requests in a timely manner and communicates resolution Collaborate with Ops compliance leadership to design and develop Medicare compliance oversight, monitoring and evaluation programs to ensure the entire Medicare organization is compliant. Research, analyze, validate and gather business process data to assess the effectiveness of the controls to ensure compliance and identify trends. Recommend improvements to ensure compliance. Track, measure, and report any identified compliance issues to leadership. Developing and rolling out compliance training. Managing the resolution of regulatory inquiries and reviews (including complaints, market conduct exams, and surveys); Consult with senior business leaders and subject matter experts on corrective action plans to improve compliance metrics and audit findings, as required. Analyze dashboard metrics, business area reports and audit results to identify and make recommendations for operational improvements and/or corrective action measures. Develop compliance dashboards, monitor and communicate results to applicable senior business leaders and compliance leadership.
Requirements of the Medicare Compliance Manager:
Bachelors Degree in Business or Health related field required
Minimum 2-5 years insurance compliance or regulatory experience, particularly in Medicare Insurance, required
Comprehensive knowledge of health insurance products and the associated sales, service, claims, and enrollment and billing processes
Knowledge of documenting walkthroughs, narratives, and flows for control identification and testing
Excellent verbal and written communication skills
strong problem solving and decision making skills
Proficient in Word, Excel and PowerPoint