Manager, Ethics & Compliance

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

📋 Description

• Oversee and execute strategies to uphold and enforce compliance programs that align with regulatory standards for designated products throughout the organization.

• Ensure that Medicare and Medicaid products and services are evaluated for adherence to program regulations, insurance standards, and overarching regulatory requirements.

• Maintain and monitor legislation, regulations, contract documents, amendments, and compliance initiatives.

• Create policies, procedures, and processes to ensure compliance with federal and state regulations.

• Provide guidance to departments regarding compliance matters and emerging compliance requirements.

• Conduct compliance audits and develop as well as implement corrective action plans.

• Execute plan risk assessments and report on trends, deficiencies, and variances.

• Deliver training on Ethics, Compliance, Risk Management, Fraud, Waste, and Abuse (FWA), privacy, and security.

• Oversee risks associated with Commercial products, benefit filings, and entity licensures.

• Work in collaboration with Marketing to oversee sales and marketing representatives and promotional materials.

• Supervise the FDR oversight program for Medicare and MMP plans.

• Report on risks related to Medicare and Medicaid products.

• Partner with departments as the local executive accountable for business continuity and disaster recovery regulatory obligations.

• Carry out additional responsibilities as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree in Business Administration, Healthcare Administration, Compliance, Law, or a related field; or equivalent experience is required.

• A minimum of 4 years of Compliance experience, ideally within a healthcare setting; or equivalent experience demonstrating relevant knowledge, responsibilities, and skills reflective of this position.

• At least 2 years of experience in Medicaid, Medicare, or Commercial Managed Care is required.

• Prior experience showcasing effective interaction with federal and state regulatory agencies in a managed care or insurance context is preferred.

• A Master's Degree is preferred.

• A Juris Doctor (JD) is preferred.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

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

• Additional incentive options may be included in total compensation.

• An equal opportunity employer dedicated to diversity.