Senior Consultant, Operations and Compliance
Responsible for day to day management of internal operations to support a remote workforce in delivery of client services. This role will ensure that our business is well-coordinated and productive by managing its procedures and processes. Also responsible for providing subject matter expertise in a client facing role on Medicare and Compliance order to effectively support our clients.
- Operations and Compliance
- Act as company liaison for vendors including staffing agencies, Information Technology, and Human Resource Administration and establish relationships as needed for efficient operations.
- In collaboration with Executive Team, develop and execute training plans and communication strategies for employee development, communication and education.
- Update and maintain corporate policies and procedures including Employee Handbook, Disaster Recovery Plan and Corporate Compliance Plan.
- Support scheduling function and client database updates and maintenance.
- Screen candidates for hire, maintain job descriptions and reserve resumes.
- Coordinate responses to IT Security surveys.
- Review vendor and employment contracts for accuracy, completeness and risk mitigation.
Part C, D and/or Compliance Subject Matter Expert
- Provide subject matter expertise in designated areas of expertise
- Provide review, interpretation and implementation of state and federal guidance
- Perform CMS mock audits of areas by specialty
- Perform operational remediation in areas of specialty
- Mentor and drive work product based on the project scope of work
- Develop, review for quality and coordinate all deliverables
- Oversee and administer ongoing monitoring programs based on CMS guidance
- Updates policies, procedures and project work plans as needed
- Adhere to established corporate policies and procedures
- Perform other duties, as necessary, to meet corporate objectives
- Travel as required
- Bachelor’s degree and a minimum of ten (10) years government, health care, pharmacy benefit management, compliance or quality profession (equivalent combination of education and experience considered.) Juris Doctorate preferred.
- Extensive experience with Medicare Part C or D and Compliance operations
- Experience with Medicare and/or Medicaid standards required
- Advanced degree or certification in audit, law or compliance discipline preferred
- Must have strong verbal and written communication skills
- Ability to maintain positive business relationships to ensure future sales
- Excellent skills in influence, negotiation and closing sales.
- 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.
- Must have strong Microsoft Office Suite skills, Advanced skills in Word, Excel, Access and PowerPoint required