Lead Compliance Oversight

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Lead and/or execute compliance-related projects and assessments from the planning phase through to reporting.

• Review the work of compliance specialists, both junior and senior.

• Ensure the successful completion of corrective action plans, both internal and external.

• Act as a subject matter expert and provide mentorship to staff and/or interns.

• Offer guidance, direction, and mentoring to associates within the department.

• Collaborate with various departments to address compliance issues through research and resolution.

• Consult with management, in-house legal counsel, and/or the VP of Corporate Compliance regarding complex compliance matters.

• Convey the significance of compliance and the compliance program to health plan personnel.

• Foster awareness of the Corporate Ethics and Compliance Program, including compliance issues, policies, procedures, and internal compliance audits.

• Coordinate with Corporate Compliance management concerning project progress and deliverables.

• Provide independent evaluations, analyses, and insights on business processes, internal controls, and regulatory compliance.

• Ensure that monitoring and oversight testing, documentation, and reporting adhere to quality, timeliness, and professional standards.

• Track the progression of internal and external corrective action plans to ensure completion.

• Educate, motivate, and assist employees in fulfilling State Medicaid Programs, OIG, and CMS requirements.

• Communicate and coordinate effectively with external auditors.

• Contribute to the annual compliance risk profile and help develop and/or execute compliance monitoring and oversight work plans.

• Support monthly, quarterly, and annual reporting to senior management and the Board of Directors.

• Undertake additional assigned projects.

⛳️ Requirements

• A Bachelor's Degree in a related field; alternatively, an additional 2 years of Compliance/Auditing experience may be accepted in place of the degree.

• Minimum of 5 years of experience in Compliance/Auditing is required.

• At least 3 years of experience in State or Federal Managed Care Programs is required.

• A minimum of 1 year of experience in reading, analyzing, and interpreting State and Federal laws, rules, and regulations is required.

• Certification in HealthCare Compliance (CHC) is preferred.

• Certification as a Compliance Ethics Professional (CCEP) is preferred.

• Certification as an Internal Auditor (CIA) is preferred.

• Certification as a Fraud Examiner (CFE) is preferred.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase programs.

• Tuition reimbursement opportunities.

• Paid time off along with holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in the total compensation package.

• Commitment to diversity-focused equal opportunity employment.