Job Description

Job Description

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health Plans is seeking to hire a qualified individual to join our team as aSenior Compliance Consultant for Medicare- Remote in VA!

Position Status: Full-time, permanent (40 hours)

Standard working hours: 8am to 5pm, M-F

Location: Remote in Virginia

Job responsbilities:

• Develops, executes and maintains an effective compliance program to prevent and detect violations of law and other misconduct.

• Promotes ethical practices and a commitment to compliance with applicable rules, regulations and internal policies and procedures.

• Provides compliance guidelines and communicates effectively with leadership at various levels, sharing opportunities for operational improvements.

• Performs audits to assess processes and controls in place to prevent and detect irregularities.

• Analyzes compliance audits, participates in fraud investigations and works compliance projects as assigned.

• Acts as a consultative resource and must be knowledgeable of regulatory requirements and complete other compliance related duties as assigned.

Minimum Requirements:

• Bachelor's degree and 7 years combined compliance/healthcare experience REQUIRED or 9 years experience, two of these years in the role as a Compliance Consultant in lieu of degree.

Preferred qualifications:

• Has experience managing multiple projects simultaneously

• Must be self-motivated

• Organized

• Possess excellent verbal and written communication skills

• Candidate should possess strong interpersonal skills.

• Proficient experience with computer software such as Word, Excel, PowerPoint, etc.

• Previous experience in Medicare compliance or quality auditor role is a must.

SentaraOverview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.

Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:

Medical, Dental, and Vision Insurance

• Paid Annual Leave, Sick Leave

• Flexible Spending Accounts

• Retirement funds with matching contribution

• Supplemental insurance policies, including legal, Life Insurance and AD&D among others

• Work Perks program including discounted movie and theme park tickets among other great deals

• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within avibrant, creative, and highly productive workplace. For information about our employee benefits, please visit:Benefits - Sentara (sentaracareers.com)

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to and use the following as your Keyword Search: JR-73333

#Indeed

#LI-PM1

Monster

Talroo - Health Plan

Managed Care, MCO, Health Plan, Healthcare, Project Management, Compliance, Regulatory, Audit, Medicare, Auditor, Regulation

Job Summary

Able to lead compliance projects independently.
Required to show independent thinking.
Assists in identifying business challenges, supporting the development of processes to address the challenges, and compliance to track and monitor business processes.
Develops, executes, and maintains an effective compliance program to prevent and detect violations of law and other misconduct.
Promotes ethical practices and a commitment to compliance with applicable rules, regulations and internal policies and procedures.
Provides compliance guidelines and communicates effectively with leadership at various levels, sharing opportunities for operational improvements. Performs audits to assess processes and controls in place to prevent and detect irregularities.
Analyzes compliance audits, participate in fraud investigations and works on compliance projects as assigned.
Acts as a consultative resource and must be knowledgeable of regulatory requirements as assigned.

Required to manage multiple projects simultaneously, must be self-motivated, organized, and possess excellent verbal and written communication skills.
Candidate should possess strong interpersonal skills.
Requires proficient experience with computer software such as Word, Excel, PowerPoint, etc.
Healthcare Compliance Cert. (CHC) or Certified Internal Auditor or master's level in a health-related field preferred.
Previous experience in accounting and healthcare law preferred.

Bachelor's degree and 7 years combined compliance/healthcare experience required or 9 years experience, two of these years in the role as a Compliance Consultant in lieu of degree.

Mastery of SQL and knowledge of Tableau
Excellent Oral and Written Communication Skills
Problem Solving
Consultative Engagement Skills
Ability to break out complex technical processes and explain to non-technical audiences

Qualifications:

BLD - Bachelor's Level Degree (Required)

Certified Internal Auditor (CIA) - Certification - Other/National, Officer of Healthcare Compliance, Certified (OHCC) - Certification - American Institute of Healthcare Compliance (AIHC)

Compliance, Healthcare, Internal/External Audit, Project Management

Skills

Active Learning, Active Listening, Complex Problem Solving, Critical Thinking, Judgment and Decision Making, Mathematics, Microsoft Office, Reading Comprehension, Social Perceptiveness, Speaking, Technology/Computer, Time Management, Writing

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission "to improve health every day," this is a tobacco-free environment.

Job Tags

Remote job, Permanent employment, Full time, Flexible hours, Shift work,

Similar Jobs