Senior Partner, PBM Compliance

📋 Description

• Offers strategic compliance advice to leaders at Select Health.

• Responsible for managing highly complex and high-risk portfolios using professional judgment.

• Designs and conducts training sessions to educate senior leaders, physicians, clinicians, and caregivers on compliance and ethics risks.

• Manages and maintains PBM/TPA licenses across all states where the organization operates.

• Directs intricate investigations and projects within the designated portfolio.

• Builds and sustains effective relationships and communication channels with stakeholders.

• Creates and executes corrective action plans and remediation strategies to resolve compliance issues or deficiencies.

• Tracks and assesses changes in the regulatory environment and enforcement landscape.

• Provides support and guidance on regulatory compliance matters.

• Designs and delivers compliance education and training programs.

⛳️ Requirements

• Bachelor's Degree in healthcare administration or a related field is preferred.

• Proven professional-level experience in a regulatory, compliance, or risk management role within the healthcare industry.

• In-depth knowledge and understanding of federal and state laws and regulations concerning healthcare billing, coding, reimbursement, contracting, and risk adjustment.

• Capability to interpret and apply complex healthcare regulations within a healthcare system.

• Excellent communication, presentation, and interpersonal skills, with the ability to influence and collaborate effectively.

• Demonstrated experience in implementing the eight elements of an effective compliance program.

• High ethical standards, integrity, and professionalism, along with a dedication to Intermountain Health's mission, vision, values, and compliance framework.

🏝️ Benefits

• Health insurance

• 401(k) matching

• Flexible work hours

• Paid time off

• Wellness programs

• Professional development opportunities

• Sign-on and relocation bonus when applicable