Medicare Compliance Manager

Accenture is a leading global professional services company that helps the worlds leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen servicescreating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 750,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the worlds leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360 value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360 value we create for our clients, each other, our shareholders, partners and communities. Visit . Strategy & Consulting: We work with C-suite executives, leaders and boards of the worlds leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360 stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional expertise is supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organizations total enterprise reinvention. As a Medicare Operations Compliance Manager , your primary responsibilities may include: Compliance Program Development: Create, maintain, and enhance the compliance program for Medicare Advantage Plans, including the development of policies, procedures, and controls. Develop a compliance roadmap that aligns with regulatory requirements and business objectives. Regulatory Analysis: Stay up-to-date with changes in Medicare Advantage regulations and industry standards. Conduct regulatory assessments and provide guidance on compliance implications. Auditing and Monitoring: Establish a robust auditing and monitoring program to assess compliance with regulatory requirements. Conduct regular internal audits and risk assessments. Compliance Training: Develop and deliver compliance training programs for employees and stakeholders within the Medicare Advantage Plan division. Promote a culture of compliance awareness and accountability. Reporting and Documentation: Prepare and submit required compliance reports to regulatory authorities as necessary. Maintain comprehensive records and documentation of compliance activities. Issue Resolution: Investigate compliance issues, violations, and complaints. Develop and implement corrective action plans and monitor their effectiveness. Cross-functional Collaboration: Collaborate with cross-functional teams, including legal, operations, and quality assurance, to ensure alignment on compliance initiatives. Serve as a subject matter expert on compliance matters. Why should I join the Accenture Health team? Innovate every day. Be at the forefront of designing and delivering Medicare and other health technology solutions that push boundaries and create new opportunities for our clients. Lead with the industrys best . Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members. Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it, youll expand your thinking beyond the core Workday implementation. Who will be successful at Accenture? Its not just what you know or where youve been that propels success at Accenture: Its who you are, fundamentally, as a person. We prize diversity in backgrounds and perspectives. Whatever your unique qualities, a few key traits should apply: Youre passionate about technology and motivated to apply the latest technology trends. Youre proactive and collaborative; a leader with effective communication skills. Youre driven by new challenges and are motivated to improve. Youre a creative problem solver with the flexibility to navigate uncertainty. Youre focused on the future with a desire to develop inclusive, responsible and sustainable solutions to complex challenges. Travel may be required for this role. The amount of travel will vary from 0 to 100% depending on business need and client requirements. Heres what you need: Bachelor's degree in healthcare administration, business, law, or a related field; Master's degree or relevant certifications preferred or 12+ years equivalent working experience. Minimum of 5 years of experience in healthcare compliance, with a focus on Medicare Advantage Plans. Minimum of 5 years of experience with strong understanding of Medicare Advantage regulations and compliance requirements. Bonus points if: Experience working with or leading global teams. Thrive in a diverse, fast paced environment. An advanced degree in the area of specialization Excellent knowledge of compliance best practices and methodologies. Executed or led a Medicare Advantage operations compliance audit. Exceptional analytical, problem-solving, and organizational skills. Strong communication and presentation abilities. Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Maryland, New York or Washington as set forth below. We accept applications on an on-going basis and there is no fixed deadline to apply. Information on benefits is here. Role Location Annual Salary Range California $93,400 to $258,500 Colorado $93,400 to $223,300 District of Columbia $99,500 to $237,800 New York $86,500 to $258,500 Maryland $86,500 to $206,800 Washington $99,500 to $237,800 Requesting an Accommodation Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. 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Created: 2024-11-05