The client is undertaking a key strategic initiative to implement new operational processes, systems and staffing models for one of its core business segments. A successful implementation will require a very plan-ful and coordinated effort and approach.
The Compliance Management Consultant position is a critical position within the program. The Compliance Management Consultant is responsible for planning and managing all aspects of the program compliance function. The incumbent will understand effective compliance, health plans and insurance industry standards and practices and ensure the implementation of new compliance laws and regulations.
Integrates the compliance program with overall regulatory compliance program.
Stays abreast of new and revised industry regulations and ensures the proper implementation.
Works with product owners as relates to compliance within the solutions of functional workstreams.
Develops and manages a plan for ensuring that effective compliance program elements are in place within the program and aligned with Corporate Compliance department with respect to:
Team training and education
Reporting and investigation
Enforcement and discipline
Monitoring and auditing
Response and prevention
Provides leadership and direction to support a comprehensive understanding and execution of compliance standards .
Directs the development and documentation for auditing and monitoring plans for all implementations.
Defines program deliverables and standards.
Conducts stakeholder analyses that identify impacted groups, needs, timelines, and more.
Actively participates as a program leadership team member; Provides input to overall issues, risks, governance and more.
Collaborates with cross-organizational programs that have dependencies (e.g. Healthcare Reform); Manages other linkages and dependencies.
Ensures operational knowledge and readiness to support the new go-to-market line of business offering.
Provides input to the overall program implementation plan.
Removes barriers for the team and ensures a collaborative work environment.
Communicates with a variety of audiences regarding compliance tactics, scope, status, progress, issues, and more.
Excellent communication, leadership & collaboration skills: Required
5+ Years of compliance-related experience: Required
5+ Years of project delivery leadership experience: Required
5+ Years healthcare domain experience: Required: Including Claims Processing, Health Management, Provider, Enrollment, Contact Center and more.
MS Office including PowerPoint, Visio & Excel and SharePoint: Required
Healthcare Reform Experience: Preferred
KELLY MITCHELL GROUP - 10 months ago
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