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Part-time, Project Based, Senior Consultant-Special Needs Plan-Model of Care (SNP-MoC)

Job Summary:

Responsible for providing subject matter expertise on Medicare Part C SNP MoC in order to effectively support our clients.

Essential Functions:

  • Subject matter expertise in SNP MoC
  • Knowledge of SNP MoC/CM/Coaching program planning, design and implementation of preventive health systems, methods and materials
  • Provides day-to-day professional and technical support to the SNP MoC team to ensure compliance with program policies and procedures, industry standards, and regulatory requirements.
  • Responsible for the integration and coordination of SNP MoC services, working closely with the client’s business analytics staff, managerial staff, and other clinical departments.
  • Ability to review, interpret and implement state and federal guidance
  • Perform CMS mock audits in SNP-MoC to confirm compliance with guidance.
  • Monitors the implementation of the corrective action plans and ensures that the result of the action plans are compliant.
  • Mentor and drive work product based on the project
  • Oversee and administer ongoing monitoring program(s) based on guidance
  • Updates policies, procedures and Audit Work Plan based as needed.
  • Adhere to established corporate policies and procedures
  • Perform other duties, as necessary, to meet corporate objectives
  • Travel as required

Qualifications:

  • Bachelor’s degree (RN preferred) and a minimum of ten (10) years government, health care, pharmacy benefit management, compliance or quality profession (equivalent combination of education and experience considered.)
  • Must have strong Microsoft Office Suite skills. Advanced skills in Word, Excel, Access and PowerPoint required
  • Experience with Medicare and/or Medicaid standards required
  • Advanced degree or certification in audit, pharmacy or compliance discipline preferred
  • Must have strong verbal and written communication skills.
  • Individual should be detail oriented with strong organization, prioritization and analytical skills with the ability to work independently.
  • Must work well under tight timelines and adapt quickly to change in a fast-paced, team-oriented, and high-growth environment.

Part-time/Project Based

BluePeak offers a flexible, work from home, telecommute environment. Project assignments are project based dependent on the engagement and the Senior Consultant’s expertise, experience and workload. Some travel required based upon project assignment.

 


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Part-time, Project Based, Senior Consultant-Special Needs Plan-Model of Care (SNP-MoC)

Thank you for your interest in the Part-time, Project Based, Senior Consultant-Special Needs Plan-Model of Care (SNP-MoC). Please provide the information below and we will contact you to schedule a call if interested. This link will remain active until the position has been filled.
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