Senior Compliance Analyst, Duals DSNP Products

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

📋 Description

• Collaborate with leadership to ensure adherence to Duals (D-SNP) Program requirements.

• Provide interpretation of regulations and conduct compliance reporting.

• Oversee special projects and design as well as implement compliance auditing and monitoring strategies for D-SNPs.

• Address external information requests necessary for Duals and SMAC regulatory submissions.

• Manage compliance reporting duties and regulatory inquiries related to Duals and Medicare D-DSNP.

• Direct Duals compliance projects and their implementation.

• Analyze and consolidate Duals regulatory requirements to formulate policies or position statements.

• Oversee the annual SMAC evaluation and monitor caps.

• Convey state and federal Duals requirements to both internal and external stakeholders.

• Facilitate the development and lead the identification, implementation, and upkeep of compliance policies, procedures, and work instructions related to Duals and overlapping Medicare.

• Identify, assess, and resolve compliance issues pertaining to Duals.

• Maintain and evaluate D-SNP regulatory documentation.

• Create, deliver, and administer Duals compliance training programs.

• Conduct periodic compliance audits, risk assessments, and ongoing monitoring efforts.

• Cultivate relationships with regulatory agencies to confirm and clarify D-SNP requirements and implementations.

• Fulfill interim responsibilities of the Duals Compliance Manager, including aiding health plan compliance officers with D-SNP duties.

• Act as a company-wide resource and liaison for Duals policies, SMAC items, contract provisions, communications, workflows, and quality improvement initiatives.

• Execute other assigned tasks and adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree in Law or a related field, or equivalent experience is required.

• A minimum of 4 years of experience in compliance and/or regulatory affairs is required.

• Experience in project management is essential.

• Familiarity with laws and/or regulations related to compliance is needed.

• Knowledge of Medicare, D-SNP, and state regulations is required.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K and stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work approach with options for remote, hybrid, field, or office schedules.

• Potential availability of incentive compensation.

• Accommodation support for applicants.