Compliance Program Manager
COMPLIANCE PROGRAM MANAGER
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Compliance Program Manager. The Program Manager will be responsible for compliance program evaluation, design and improvement to ensure development, integration and execution of compliance initiatives and requirements are in support of organizational processes, operations and administrative efficiency.
The essential duties and responsibilities will include the following:
- Partners with Chief Compliance Officer (CCO) to ensure the Compliance Program, controls and activities are implemented based on communication, collaboration, and transparency within the organization.
- Establishes and maintains effective relationships with peers and stakeholders, internal and external to the organization to ensure compliance controls, activities, goals and objectives enable the organization to achieve its mission and vision.
- Designs, implements and monitors a program to ensure NCQA accreditation is maintained; collaborating with peers and business owners in identifying resources necessary to achieve and maintain highest level accreditation status.
- Creates criteria to evaluate Compliance Department and Program goals, projects and initiatives to validate outcomes and devise future opportunities for improvement.
- Evaluates and improves systems, processes and interactions between the Compliance Department and business owners to achieve high quality operational outcomes.
- Ensures alignment of government affairs, regulatory affairs and compliance operations to provide appropriate front and back-end support to business units.
- Participates cross-functionally in business planning to support business unit strategy.
- Contributes to project teams, assigning and monitoring work of team members and providing guidance and leadership.
- May act as the business unit liaison to organizational initiatives and projects.
- Maintains current knowledge of the business and regulatory environment relative to the business and regulatory environment.
- Educate and work with external partners and participating practices as needed to identify innovation opportunities and adopt improvement actions.
- Perform other duties as assigned
Education and Experience: Bachelor’s Degree in Business Administration, Health Care Management or Public Policy required. MBA, MPH or MPP preferred. Minimum three (3) years of managed care experience preferably with Medicare/Medi-Cal experience. Experience with quality improvement/process improvement techniques required. Previous project/program management experience required.
- Knowledge of: Personal computers and proficiency in Microsoft Office Suite applications, including Outlook.
- Word, Excel, Access and PowerPoint. Relationship Building and Interpersonal Skills. Financial/Quantitative
- Acumen. Change management, process improvement and redesign. Organizational behavior skills with a
- Focus on driving for results. Project management, program evaluation and consulting skills. Knowledge of
Accrediting/regulatory body requirements
Ability to: Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Think critically and make informed decisions.
Compensation and Benefits
Starting Compensation Range: - Depending on Experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.
File by: Continuous until filled. The Health Plan of San Mateo is proud to be an Equal Opportunity Employer and encourages minority candidates of all backgrounds to apply.
Submissions without a Cover Letter and Salary Expectations may not be considered.