Compliance Manager

Compliance Manager Compliance Manager Who are we? Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide.
We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.
As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents.
We are also invested in your success.
There are many opportunities for advancement and development throughout all stages of your career with us.
See how you can make a difference with the support of strong leadership and a team environment.
See Everything, Be Anything™.
What are we looking for? The Compliance Manager, under direction of the Senior Director, Compliance Operations and Privacy, manages the execution of the Compliance work plans related to FDR oversight, and internal operational/regulatory audits and monitoring.
In addition, the Compliance Manager will participate in audits and identify areas of continuous improvements to the Compliance program.
The Compliance Manager will manage audit staff and perform other duties as assigned.
Where you will have an impact • Manage and participate in the execution of operational/regulatory audits and monitoring in accordance with CMS Audit Protocols, CMS regulations, federal and state regulations, and client SLAs, and known industry areas of risk.
• Manage audit staff and serve as subject matter expert in CMS Audit Protocols and Market Conduct Exam areas of risk.
• Assist in writing and review of audit engagement letters and audit reports for accuracy, spelling and punctuation, and ensuring that audit objectives were met.
• Facilitate audit kick-off meetings with internal stakeholders and FDRs.
• Oversee development, monitoring, validation, and reporting of all Corrective Action Plans (CAPs) resulting from audits and monitoring of internal business owners and FDRs.
• Oversee and maintain accurate documentation of monitoring results in the Compliance Dashboard and FDR Oversight Dashboard.
• Stay abreast of external and internal emerging risks to the organization.
• Create and update department policies, desktop procedures, and audit guides.
• Perform other duties as assigned.
What’s necessary to do the job? • Bachelors in business or healthcare administration, or related field preferred.
In lieu of education, must have at least 5 years of related experience.
• Minimum of five (5) years of experience in the Medicare Advantage health insurance industry required.
Knowledge and experience in Medicaid Managed care and Affordable Care Act a plus.
• Experience working in managed care insurance operations, preferably in claims, appeals and grievances, or call center, a plus.
• Minimum (5) years of compliance / regulatory auditing experience using CMS Audit Protocol methodology required.
• Minimum of three (3) years in a supervisory or managerial role in the managed care industry.
• Must have excellent verbal and written communication skills.
HIPAA & Security Requirements All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.
As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times.
As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce.
All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
The wage range for applicants for this position is [$110,000.
00 to $120,000,00].
All incentives and benefits are subject to the applicable plan terms.