- Act as primary contact for regulatory auditors
- Distribute requests to staff as needed
- Review submissions
- Develop and maintain training and requirements documentation and instructions and provide training as required
- Support business units in interpretation of regulations related to their applicable areas as well as aid in developing appropriate tools to ensure compliance
- Manage staff who will:
- Assign CAPs in OMT to functional leaders as needed
- Monitor CAP completion to ensure timely completion
- Work with Executive Leadership Team (ELT) for sign-off and validation CAPs completed
- Standard office conditions.
- Position requires constant operation of a computer and other office equipment (i.e., copy machine, Polycom equipment, and computer printer)
- Must be able to remain in a stationary position 50 percent of the time
- Bachelor's Degree or equivalent experience required,Masters degree in health care administration, public administration, public health, or business administration preferred.
- HCCA Certified in Healthcare Compliance (CHC) preferred
- 5 or more years direct work experience inregulatory affairs and/or compliance in Medicare or Medicaid required
- 5 or more years of managerial experience required
- Health care industry experience required
- Project management skills or equivalent required.
- Strong written, verbal, listening and communication skills
- Strong supervisory/managerial skills.
- Manage staff workload appropriately and identify areas of improvement and areasfor professional development for staff
- Strong analytical skills
- Strong project management skills
- Strategic thinking and planning in order to continue to enhance the ComplianceProgram and the role of compliance within the organization; ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions
- Ability to influence team members and owners to resolve issues in a timely manner
- Requires diplomatic and negotiation skills and understanding of needs of internal andexternal partners
- Ability to work independently
- Ability to present information clearly in meetings and to communicate with teammembers and senior leadership
- Requires excellent interpersonal skills in order to communicate and work with staff of all skill and experience levels
- Self-directed with proven initiation skills
- Must be able to effectively communicate with colleagues, internal customers, and vendors
- English
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Sr. Manager, External Audit - Boston, United States - Commonwealth Care Alliance
Description
Why This Role is Important to Us:
Under direction of the Sr.
Director of Regulatory & External Audits, the primary focus areas of this position includes managing external audits and resulting Corrective Action Plan (CAP).
This includes audits from external regulatory agencies including but limited to Centers for Medicare & Medicaid Services (CMS), Mass Health, Departments of Insurance, and the Office of Inspector General (OIG).
Supervision Exercised:
Yes, which includes but is not limited to providing leadership, work direction, and performance feedback to subordinate staff.
What You'll Be Doing:
Oversight of CCAs External Audit Process
Corrective Action Plan (CAP) Management
Working Conditions:
What We're Looking For:
Qualifications:
Required Knowledge, Skills & Abilities:
Required Language:
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
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